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Hand-Book 



Digestive Ferments 



LIBRARY OF CONGRESS. 



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UNITED STATES OF AMERICA. 



Fairchild's Hand-Book 

OF THE 

Digestive Ferments 



AS REMEDIES, PER SE 
AS SURGICAL SOLVENTS 

AND IN THE 

PEPTONISATION OF MILK AND OTHER 
FOODS FOR THE SICK 

AND FOR 

THE MODIFICATION OF COW'S MILK TO THE 
STANDARD OF HUMAN MILK 

BY THE FAIRCHILD PROCESS 




FAIRCHILD BROS 



NEW YORK 
82 & 84 FULTON STREET * 
LONDON WESTERN DEPOT 

SNOW HILL BUILDINGS IIO RANDOLPH STREET, CHICAGO 



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Copyrighted by 

Fairchild Bros. & Foster, 

1892.— Also 1898. 




Fairchild'-s Preparations. 



Pepsin in Scales, 

Pepsin in Powder, 

Essence of Pepsine, 

Saccharated Pepsin, 

Glycerinum Pepticum, 

Extractum Pancreatis, 

Diastasic Essence of Pancreas, 

Peptonising Tubes, 

Peptogenic Milk Powder, 

Panopepton, 

Pancreatic Tablets, 

Compound Pancreatic Tablets, 

Pepsin and Extract Pancreatis Tablets, 

Pepsin and Bismuth Tablets, 

Pepsin, Bismuth and Pancreatic Tablets, 

Pepsin, Bismuth and Nux Vom. Tablets, 

Pepsin and Diastase Tablets, 

Peptonate of Iron Tablets, 

Compound Ox Gall Tablets, 

Ferroglobin Tablets, 

Trypsin. 



'HE Various Uses of the Fairchild Digestive 
Ferments described in the pages of this pamphlet, 
afford striking evidence of the great progress made 
in their development and practical application, in the past 
decade. The manufacture of the Pepsin in Scales and the 
Extractum Pancreatis was undertaken with an enthusiasm 
based upon our conviction of the valuable properties and 
possibilities of the gastric and pancreatic ferments as 
therapeutic and as peptonising agents, and of the inferior 
and often useless character of the pancreatines and pep- 
sins of the market. 

Such was the demand made upon our time and upon 
our resources, that we soon found it expedient to re- 
linquish the general drug business in order to devote 
ourselves exclusively to the digestive ferments. In this 
work we have sought to develop and perfect the means 
and the methods of their employment in every useful 
direction ; and we have been happy to see them assume 
so important a place in practical medicine ; a place won 
on the basis of properties actually demonstrated and 
applied. 

The modern application of the digestive ferments 
by the Fairchild process to the predigestion of food for 
the sick may be considered as direct, natural and scientific 
a development of the resources lying at our hands, as the 
art of cookery itself, by which we seek to perfect the 
adaptation of food stuffs to the needs of mankind. 

In no direction has a digestive ferment been of more 
positive benefit and radical improvement than in the prep- 
aration of infant food. The use of a digestive ferment as 



the essential factor in a method for the preparation of an 
artificial human milk, was first suggested and brought to a 
practical form by us in the Peptogenic Milk Powder. 

So strong is our conviction of the soundness of the 
principles upon which this method is based, of the accuracy 
with which it is brought into practice, so conclusive the 
evid-ence of its beneficent results in actual use, that we feel 
constrained to urge its claims to consideration as a means of 
obtaining a complete and exclusive substitute for breast 
milk. 

As surgical solvents the digestive ferments justify seri- 
ous attention, for they are potent, are painless in their 
work and invade and liquefy dead tissue straight down to 
living ones, where their action ends abruptly ; they impart 
moreover a distinct stimulus to the healing process. 

The Fairchild preparations are each and all the result 
of persistent, careful, special work, and we believe them 
to be not only the original, but the best, for all the 
purposes designed. They have long been conceded to be 
the standard. 

We desire to take this occasion to again express our 
appreciation of the confidence and recognition so gener- 
ously accorded to our efforts by the medical profession. 
It is no less a source of pleasure to us that so many of 
the best pharmacists find our products worthy of their 
careful and discriminating preference. 

FAIRCHILD BROS. & FOSTER. 

Revised Edition, April, 1893. 



CONTENTS 



Digestive Ferments — General Characteristics. 

Action of ; Limit of energy ; Changes of alimentary substances 
by digestion ; In a dry form, should not be hygroscopic ; Dry 
ferments compatible with substances which would injure them in 
solution ; Dry compounds as subject to assay as the separate fer- 
ments from which prepared ; Relation to temperature ; In solution ; 
Incompatibility of solutions of mixed ferments pp. 10-16 

Alcohol and the digestive ferments ; Action of strong and diluted ; 
Value as a preservative. . . . ^ pp. 16-18 

Inhibitants. The influence of drugs and dietary substances upon the 
process of artificial digestion ; The relation of test tube experi- 
ments to the conditions of body digestion ; necessity of dis- 
tinguishing between substances which retard the process of arti- 
ficial digestion and substances which destroy the ferment, .pp. 19-22 

Incompatibles. Substances and conditions which destroy the digestive 
ferments ; Pepsin and bismuth in solution pp. 23-25 

Antiseptics pp. 25-26 

" Jumbles." Character of the commercial digestive compounds, their 
good effects due to pepsin and acid p. 26 

Vegetable Ferment. Its inferiority in comparison with pepsin in 
acid media and pancreatic extract in alkaline or neutral. . .pp. 27-28 

Gastric Ferments. Pepsin, its action upon albumen ; Peptic peptone ; 
Pepsin inert in alkaline solution ; Pepsin and soda ; Practical uses 
of pepsin pp. 28-30 

Milk Curdling Ferment of the Gastric Juice. Its action upon 
caseine ; Significance in the digestive process pp. 30-32 

Pancreatic Ferments. Trypsin, Action of ; Tryptic peptones ; Pan- 
creatic diastase ; Identity of diastase from all sources in properties 
and action ; Uses of Emulsive Ferment ; Curdling ferment 

pp. 32-3S 

Dosage of digestive ferments pp. 35~3 6 



Fairchild Preparations of the Digestive Ferments ; Uniformity and 
reliability ; Their repute based upon actual demonstrated proper- 
ties ; Commercial imitations and substitutes therefor pp. 38-42 

Pepsin in Scales and Powder. The most active and desirable pep- 
sin for administering in a dry form ; Pepsin in scales first intro- 
duced by Fairchild ; Absolute permanency pp. 42-43 

Pepsin Saccharated. Feeble power of ; Only officinal dry pepsin 
preparation p. 43 

Glycerinum Pepticum. A pure glycerin extract from the gastric 
membrane, free from alcohol, antiseptics, sugar or flavoring ; The 
best soluble form of pepsin pp. 43-44 

Essence of Pepsine, Fairchild's, Obtained by direct maceration from 
the fresh calf rennet ; Special value as a remedy in disorders of 
infancy, and dyspepsia of adults ; As a means of administering 
drugs which disturb the digestive functions and impair the appetite ; 
As a practical rennet agent pp. 45-47 

Medicated Junket. Suggested by Dr. Delavan ; Milk-curd made with 
Fairchild's Essence containing Potassium Iodide m solution, the 
curd holding iodide suspended in a very agreeable form . . pp. 47-48 

Pepsin Testing pp. 48-52 

Pancreatic Preparations. Extractum Pancreatis containing all the 
ferments of the pancreas in an active and available form ; As a 
remedy per se ; As a diastasic, proteolytic and emulsifying agent ; 
Its special value in intestinal indigestion pp. 52-57 

Trypsin, Fairchild's. As a solvent of diphtheritic membrane. . . .p. 57 

Diastasic Essence of Pancreas, especially for the digestion of fari- 
naceous foods p. 58 

Peptonising Tubes, for the preparation of Peptonised Milk, etc. .p. 59 

Direction Slips. For prescribing Peptonised Milk, etc p. 59 

Peptogenic Milk Powder p. 60 

Tests for pancreatic preparations pp. 60-62 

Digestive Tablets, Fairchild's. Pepsin Tablets ; Pepsin and Bismuth 
Tablets ; Pepsin, Bismuth and Pancreatic Tablets ; Pepsin and 
Pancreatine Tablets ; Pepsin and Diastase Tablets ; Pepsin, Bis- 
muth and Nux Vomica Tablets ; Compound Ox Gall Tablets ; Pan- 
creatic Tablets ; Compound Pancreatic Tablets ; Peptonate of Iron 
Tablets ; Ferroglobin Tablets pp. 62-67 

Peptonising Process. Simplicity, economy and practicability of ; 
Use of soda in ; Reasons for diluting milk in pp. 67-73 



Uses of Peptonised Foods. In Typhoid Fever ; pneumonia ; gastric 
ulcer ; acute dysentery ; diabetes ; tuberculosis ; chronic diarrhoea ; 
gastric catarrh ; value as exclusive diet even in active life. pp. 73-76 

Peptonised Milk. Ideal food for the sick pp. 77-78 

Nutritive Enemata. Milk, beef, etc pp. 78-79 

Panopepton — Bread and Beef Peptone ; a properly digested, complete 
nutrient pp. 79 82 

Surgical Use of the Digestive Ferments. As solvents for false 
fibrinous membrane, coagula, muco-pus, necrotic and carious bone ; 
applied in aural cavity, urethra, bladder, etc pp. 83-90 

Peptogenic Milk Powder. For the preparation of humanised milk, 
Identical with normal human milk in physical, chemical and physio- 
logical properties ; Rationale of the process ; Agency of the diges- 
tive ferment as an innocent, practical, and only known means of 
converting caseine into the soluble form characteristic of the 
albuminoids of human milk pp. 91-94 

Infant Foods. Only practical point of inquiry ; How do they compare 
with breast milk when prepared for the nursing bottle ; Fresh cows' 
milk only practical basis for making an infant food ; Milk Foods, 
etc. ; Impossibility of drying pure milk pp. 94-95 

Cows' Milk. Proven inherently indigestible for an infant's stomach ; 
Common methods of preparing it for infants ; Liebig's Food ; 
Farinaceous Food pp. 95-97 

Comparative Composition of Cows' and Human Milk. Differ- 
ence in their physical characters, digestibility behavior with gastric 
juice directly due to difference in their albuminoids ; significant 
difference also in proportion and quantity of nutritive materials 

pp. 97-98 

Use of Peptogenic Powder. Includes the preparation of an exact 
quantitative imitation of human milk, exact qualitative change of 
albuminoids and subsequent destruction of the ferment. . .pp. 98-99 

Directions for "Humanised Milk"; in health and in feeble 
digestion pp. 99-100 

Composition of "Humanised Milk." Remarkably like average 
breast milk in chemical constitution, reaction, density, color, taste 
and in behavior under all conditions p. 100 

Digestibility of "Humanised Milk"; Not unnaturally easy of 
digestion ; as digestible as mothers' milk ; adapted for feeble diges- 
tion by increasing the pre- digestion of the caseine. ...pp. 101-102 

Cholera Infantum. Whey as a temporary food in pp 102 104 



9 

How Long Should Infant be fed upon humanised milk ; Human- 
ised milk the only food suitable during entire nursing period. p. 104 

How to Wean the bottle fed baby pp. 104-105 

As A Partial Substitute for Breast Milk ; Humanised milk most 
successful partial food, because so like breast milk p. 105 

No Special Effect upon the Bowels from " humanised milk " 

pp. 105-107 

Changing the Food ; Evil of going from one food to another without 
definite knowledge or basis of selection pp. 107-109 

Rich Milk from one cow ; Cream : Temperature of the water bath ; 
Milk tastes bitter ; Milk curdled when boiled pp. 109-112 

Condensed Milk pp. 112-113 

Sterilised Milk. Character of ; Effect of sterilising process ; less 
digestible and far less nutritious than fresh milk pp. 11 3-1 15 

Comparative Analyses average of 80 samples of woman's milk and 
of " humanised milk," by Dr. Albert R. Leeds p. 116 

Fairchild's Practical Recipes ; For peptonising food for the sick ; 
Nutritive value of milk compared with beef tea, extracts of beef, 
etc ... . pp. 117-118 

Peptonised Milk. Warm process ; Cold process ; Hot, as a bever- 
age ; Effervescent ; Special for jellies, punches, etc. ; Punch ; 
Lemonade ; Peptonised milk gruel ; Peptonised porridge ; Beef ; 
Oysters ; Junket and whey with Fairchild's Essence of Pepsine ; 
Partial digestion of farinaceous foods at the table pp. 1 19-125 

List of Fairchild's Preparations p. 126 



10 

DIGESTIVE FERMENTS. 

In the digestive ferments, we have to deal with an 
entirely distinct class of agents, bearing little or no 
analogy to drugs and chemicals. They are not known to 
exert any action in the body other than that concerned 
in the conversion of alimentary substances into soluble 
and absorbable forms. By this action alone we know 
them and can determine their presence. 

No digestive ferment has been absolutely isolated, 
consequently the chemical constitution of these principles 
is yet a matter of conjecture. We do not know how they 
perform their marvellous work, nor the exact chemical 
formula of the various derivatives of digestion. These 
limitations to our knowledge of the digestive ferments do 
not impose any limitations upon our practical use of 
them. For we are able to extract them from the diges- 
tive juices or secreting glands and to preserve them 
indefinitely as reliable agents of the materia medica. We 
know well the conditions under which they act, what is 
unfavorable to their action, what is directly destructive 
to them. 

We can as unerringly detect the presence of pepsin 
or diastase as that of morphia or strychnia. We can 
readily ascertain the digestive power or value of any 
given product. The physical changes of alimentary 
bodies under artificial digestion are so characteristic, so 
apparent to sight and taste that they afford convenient 
and familiar evidence by which the peptonising process 
may be as readily regulated as that of cooking. 

It is true, the digestive ferments are profoundly sensi- 
tive to influences which have little or no effect upon the 
medicinal properties of drugs and chemicals. Further- 
more, there have been many fallacious statements and 



11 

theories concerning the digestive ferments, and the im- 
mense array of experiments, with the theoretical discus- 
sions thereon, have also tended to give an undue impres- 
sion of peculiar difficulties attending their practical use. 
The truth is that the digestive ferments may be prescribed 
with the same certainty, with as definite and well 
grounded anticipation, with as little difficulty as regards 
incompatibility, as in the use of drugs and chemicals. 

The digestive ferments find their entire use in three 
distinct directions. First, as remedies per se, as aids to 
the digestive process within the body. Here the main 
concern of the physician is to avoid prescribing the diges- 
tive ferments with substances which injure them ; there 
are but few of these at all likely to be prescribed with the 
digestive ferments and they are in the discussion of 
" Incompatibles " conveniently summarised for reference. 
In the therapeutic use of the digestive ferments the influ- 
ence of drugs, etc., on the process of digestion is apt also 
to be considered. This question is, however, without 
practical bearing here. For the action of the so-called 
" inhibitants " is only ascertained in the test tube where 
the action of each ferment is clogged even by the prod- 
ucts of digestion and retarded by substances which in the 
stomach would have no influence whatever. Under the 
subject of " inhibitants, ,, the relation of these experi- 
ments to the conditions of body digestion and the deduc- 
tions to be drawn therefrom are fully discussed. 

In the artificial digestion of foods, the relation of the 
digestive ferments to temperature is such that simply by 
its regulation, we may obtain their energetic action, may 
hold the ferments in a latent form, or instantly and per- 
manently check action at any given stage, as described in 
the peptonising process. 

For the solution of morbid tissue, we have but to em- 



12 

ploy the special ferment indicated, in its proper vehicle, 
and remove by irrigation both the ferment and the dis- 
solved matter. The certainty with which the Fairchild 
preparations of the digestive ferments act, either upon 
alimentary bodies, or morbid tissues, affords sufficient 
proof that the digestive ferments are not necessarily vari- 
able or unreliable agents. 

Our work with the digestive ferments has been of that 
practical character involved in the production of these 
organic principles in the most active and best form ; and 
in the invention and development of preparations and 
processes for their application. In the following pages, we 
have sought to present the salient facts concerning the 
digestive ferments in the whole range of their relations 
to the conditions and agents with which they are prac- 
tically brought into contact, and to describe the proper 
methods for their employment as therapeutic and pepton- 
ising agents. 

DIGESTIVE FERMENTS. 

GENERAL CHARACTERISTICS. 

The digestive ferments belong to the class of soluble 
unorganised ferments, possessing no power of self-nutrition 
or self-multiplication. They differ entirely in their mode 
of action from living ferments, such as yeast or bacteria. 
Their action is further unaccompanied by the phenomena 
ordinarily associated with fermentation. They may be 
described as agents capable of setting up between sub- 
stances, under conditions of moderate temperature, a chem- 
ical action of which these substances are incapable without 
the intervention of the ferment. The digestive ferments 
probably belong to the proteid class, or are closely related 
thereto. At present in the most active form in which they 



13 

are practically obtained, they are found to correspond in 
behavior and constitution to proteid bodies. They are all 
soluble in water, and by simple infusion of the fresh gland 
or the secreting membrane, we may obtain active solutions 
which exhibit in the proper media all the behavior of the 
natural juices. They resemble in a degree all ferments in 
their energy, in the minute proportion required in the con- 
version of alimentary substances. 

Stress has been laid upon the fact that a ferment after 
having performed a certain amount of digestion may be 
recovered and made to repeat its work, and it has been by 
some writers assumed that the power of a ferment is limit- 
less. Even if this theory were true, it has no bearing upon 
ordinary operations with a digestive ferment upon its cor- 
related substance, to determine its extent of energy under 
definite conditions or to utilise its force. Nor is it of any 
significance as to the role of the ferment in the normal 
process of digestion. It is of no bearing whatever in the 
use of the ferment for any practical purpose, for artificial 
solvents of alimentary substances or of morbid tissues, 
etc., or as aids to digestion. 

It is, however, a fact that the digestive ferment has a 
definite, ascertainable limit of energy ; its power is used up 
just in proportion to the work done. 

When under certain conditions favorable to digestion, 
with arbitrary proportions of alimentary substance and 
media a point is found at which a given amount of ferment 
leaves a large excess of substance unaffected, it is because 
the ferment has lost all its power. Thus in a series of 
experiments with increasing ratio of substance to ferment, 
we ascertain the relative as well as actual power of pepsin 
or diastase for instance. 

The characteristic action of the digestive ferment is 



14 

the conversion of alimentary substances into the peculiar 
soluble form essential to their absorption. But the action 
of the ferments is not restricted to alimentary bodies ; 
the proteolytic ferments, both of the stomach and the 
pancreas gland, are capable of digesting albuminous or 
fibrinous substances, such as false membranes, coagula, etc. 

It is under physiological conditions that the ferments 
produce changes which can otherwise only be approximated 
under high temperature and chemical reagents ; as, for 
instance, in the making of peptones or glucose by prolonged 
boiling with acid. The change which all alimentary bodies 
undergo during digestion profoundly affects their physical 
properties, and consequently their susceptibility to osmosis, 
whilst their chemical composition is but slightly altered. 
In order to distinguish the digestive ferments from living 
or organised ferments, Kuhne proposed to call them 
enzymes, and further it has been proposed to distinguish 
their action as enzymatic, in contrast to true fermentation. 
But these terms have but little practical recognition, and 
the distinctions between digestive ferments and living, 
yeast, or germ ferments, are now so weAl understood that 
the use of the term " digestive ferments " really leads to 
little confusion. 

In a dry form the digestive ferments permanently retain 
their properties. For inasmuch as water is essential to the 
action of the digestive ferment so the presence of water is 
essential to its reaction with any other substance. Moisture 
and heat are favorable to their decomposition. An essential 
quality of dry products of the digestive ferments is, that 
they shall not be prone to absorb moisture — shall not be 
hygroscopic. They should never be prescribed in combina- 
tion with deliquescent salts, peptone, etc. A digestive 
ferment may properly be combined in a dry form with sub- 
stances with which it should not be brought into contact in 



15 

solution. Thus dry pepsin will not be injured by contact 
with soda bicarbonate. 

Obviously in a dry form, the digestive ferments are with- 
out action towards each other. Therefore, a mixture of 
these ferments should retain, and under proper conditions, 
must exhibit the behavior characteristic of each one of the 
ferments contained. For with several ferments placed in a 
digesting mass, those under conditions unfavorable to action 
have no possible interference with the action of the partic- 
ular ferment for which the conditions are appropriate. A 
digestive compound is therefore, in every particular, as 
subject to assay as the separate ferments from which it is 
prepared. For instance, if a powder contains "pepsin, 
pancreatine and diastase," it should in acidulated water, 
give all the results of the contained quantity of pepsin, in 
an alkaline medium it should digest fibrin or milk, and in a 
neutral or alkaline solution liquefy gelatinous starch. What- 
ever theory or opinion may be held concerning the propriety 
of such combinations, it must certainly be obvious that 
their value as digestive agents must as much depend upon 
the possession of the digestive properties of the various 
ferments, as the value of a preparation of pepsin or of pan- 
creatic extract is measured by the degree in which it ex- 
hibits peptic or pancreatic activity. 

The digestive ferments are inert but not injured, at a low 
temperature. They bear prolonged exposure to the freez- 
ing-point without becoming impaired. In solution, at the 
ordinary temperature of a room, 70 F., they act slowly^ 
favorably at the temperature of the body, and increas- 
ingly up to about 130 F., when as the temperature rises 
they sharply diminish in activity until at about 160 F., 
they are quite destroyed. 

Pepsin is active only with acid ; pancreatic ferments in 
neutral, alkaline and feebly acid solutions. 



16 

It is impossible to prepare a menstruum suitable for 
the solution and preservation of mixed ferments of the 
pancreas and the stomach. If we mix active solutions of 
the stomach and of the pancreas and test the mixture after 
it has been set aside at the ordinary temperature of the 
room for a few days, it will be found that the mixture no 
longer represents all the digestive ferments as contained 
in the original solutions. If the reaction of the solution 
of the mixed ferments has been neutral or alkaline, the 
pepsin will have been destroyed ; if acid, the pancreatic 
ferments will have lost their properties. It may be said, 
therefore, without qualification, that the whole class of 
fluid mixtures of gastric and pancreatic ferments are un- 
scientific, and invariably devoid of most of the ferments 
they purport to contain. 

ALCOHOL AND THE DIGESTIVE FERMENTS. 

The digestive ferments vary so little in their behavior 
with alcohol, that they may all be said to bear a common 
relation to it. They are insoluble in alcohol, soluble in 
diluted alcohol and precipitated from solution by alcohol in 
excess. 

To effectually employ alcohol as a precipitant of the 
ferments, they must be held in a concentrated solution, to 
which the stronger alcohol must be added in such a volume 
as to give the largest practicable percentage of absolute 
alcohol. The ferments so recovered, may again be re- 
dissolved in water. 

That alcohol does not destroy the ferments, may be 
seen in the method commonly employed by physiological 
chemists, in extracting the ferments in a pure solution 
convenient for experimental purposes. The mucous mem- 
brane or gland is first exposed to alcohol which washes, 
hardens and dehydrates it ; then to a solvent (glycerin 



17 

preferably) which takes up the ferment largely free from 
inert extractives, coloring matter, etc. 

But notwithstandidg the fact that alcohol is thus recom- 
mended in leading works on physiology, we have been 
unable to convince ourselves that strong alcohol does not 
exert a direct injurious action on the ferments. The alco- 
hol separated ferment does not exhibit the activity which 
it should theoretically possess, calculated upon the degree 
of isolation and the known assayed ferment power of the 
original infusion of the gland. But the degree of activ- 
ity suitable for the physiological chemist, who simply 
requires solutions of the ferments capable of exhibiting the 
characteristic reaction, is no doubt far inferior to the 
standard attained by the manufacturing chemist in apply- 
ing ferments to practical purposes. 

From a pharmaceutical standpoint alcohol bears in some 
respects the same relation to the digestive ferments as it 
does to many drugs. A watery infusion from the stomach, 
like all other infusions of organic substances, will be soon 
decomposed and the ferments therein will lose all activity 
unless there is some preservative added. A hydro-alcoholic 
menstruum serves as useful a purpose in extracting the 
digestive ferments as it does in extracting the active prin- 
ciple of drugs. The first desideratum of fluid preparations 
is that they should present effective doses in a moderate 
volume. With a menstruum containing say 15 to 20 per 
cent, of pure spirit, all the ferments may be extracted and 
preserved in an effective form for medicinal purposes 
or for use in the artificial digestion of food. It is not 
by any means a sufficient cause for the rejection of this 
class of preparations, merely because they contain alcohol 
up to say 20 per cent, of volume, In the percentage 
sufficient as a preservative, alcohol does not necessarily 
injure the ferments or render them inert. As present in this 



18 

proportion it becomes an insignificant factor in so far as it 
affects the value of a digestive fluid, owing to the dilution 
it will receive in practical uses. 

We must require of such a preparation as the essential 
ground of its employment, that it shall exhibit actual diges- 
tive power, the characteristic action of the ferment which it 
purports to represent, when submitted to the identical con- 
ditions used in assaying the dry ferments themselves. 

The solutions or liquid extracts from the pancreas are 
objectionable and inferior to the dry Extractum Pancreatis, 
not because of the 20 p. c. of alcohol, but because of 
the tendency of these solutions to precipitate, to undergo 
deterioration owing to the large amount of organic matter 
they contain. The diastasic power is especially variable 
and weak, and tends to constantly diminish. These solu- 
tions further impart their peculiar repulsive taste to foods, 
milk, gruel, etc., and consequently they have found little 
usage, and now are entirely superseded by the Extractum 
Pancreatis. 

The question of the influence which alcohol exerts upon 
the artificial process of digestion, its bearing upon the proper 
use of alcohol in fluid preparations of the digestive ferments, 
will be discussed when we come to consider the subject of 
inhibitants or substances which retard artificial digestion in 
the flask or test tube. 

That many of the class of preparations, such as wines, 
elixirs,etc, are inefficient, is not due to thepresence of alcohol, 
but for the reason that they have not been properly pre- 
pared, or have been made from commercial products 
originally deficient in digestive properties. For this class of 
preparations of the digestive ferments will be found to vary 
very much, as do galenical preparations generally, according 
to the skill and technical knowledge exercised in their 
manufacture. 



19 
INHIBITANTS. 

No question concerning the digestive ferments has 
been given more attention than the influence of medici- 
cinal and dietary substances upon the process of artificial 
digestion. It has been the subject of many experiments 
and raised many speculations. We have had elaborate 
tests, giving the exact observed degree of retardation 
exhibited by a great variety of drugs and chemicals, 
some of which would scarcely by any chance ever be 
mixed with a digestive ferment in practice ; also of the 
effect of alcohol, wine, spirits, beer, tea, cocoa, coffee, 
whey, sugar, common salt, etc. That various observers 
reach conflicting results and conclusions is due to the 
fact that no two employ digestive fluids of the same 
strength or follow precisely the same method in detail. 
Whilst these experiments are very interesting and attrac- 
tive, the real point of inquiry must be to determine their 
practical bearing in medicine and pharmacy. There is a 
very necessary distinction to be drawn between the 
action of substances upon the ferments direct and upon 
the digestive process. It is of the greatest importance 
to the physician and the pharmacist to know the agents 
which destroy the ferment when brought into contact 
with it. But as to the practical significance of this whole 
class of experiments showing the retarding effect of sub- 
stances upon the process of digestion, we must consider 
what relation or resemblance exists between the condi- 
tions in the test tube and in the living body. We must 
ask why and how these agents retard digestion and if 
they are likely to produce similar results when they are 
taken into the body. The common method of experi- 
ment is to take, say with pepsin for illustration, a definite 
amount of the ferment, albumen, acid and water up to an 
arbitrary volume, the proportions adjusted to produce a 
known amount of digestion in a definite time at blood 



20 

heat. This constitutes the control test. Into this mix- 
ture, in a series of tubes, are added the agents to be 
tested and the effect upon digestion noted. These con- 
ditions in the test tube imitate those of the digestive 
tract in temperature and in media ; they differ therefrom 
in material points. In the test tubes, the very accuracy 
of the proportions of the mixture, whilst essential to cor- 
rect observation in experiments, in reality involves a great 
fallacy. Water is essential to all physiological action ; 
water is the only fluid in which and by which a digestive 
ferment can act upon an alimentary substance. In the 
stomach and intestinal canal there is not an arbitrary fixed 
volume of liquid, which may be to a definite and known 
degree altered by the addition of any substance. In the 
normal digestive apparatus, the ferment may be said to 
act in a current of water ; there is a constant secretion 
of digestive juices during the entire period of action. 
There is meanwhile a marked fluctuation in the reaction 
and the composition of the digesting mass, owing to the 
very complex nature of the substances of food and the 
more or less definite chemical changes and combinations 
formed therefrom. The products of digestion, the saline 
constituents of food, are continuously absorbed in the 
digestive tracts, leaving the digestive juice unhampered 
in its work. In the test tube in the "control," the 
first essential is a fixed volume of water. Now if in 
another tube, we add a substance which reduces the pro- 
portion of water to any marked extent, we shall find, as 
may only be anticipated, that we get less digestion. A 
tube containing 80 per cent, of water and 20 per cent, of 
alcohol or glycerin or sugar or peptone, will give less 
result, not because these substances injure the ferment, 
but because they cannot replace water, because of the 
lessened value of the media for digestive action. Pure 
glycerin exerts no injurious action upon a ferment, but 



21 

the ferment cannot transform albumen into peptone in 
glycerin. Again, we see in artificial digestive operations 
that when the fluid has become saturated with the prod- 
ucts of digestion, the ferment can act no further. Not 
because peptone injures pepsin or maltose injures dias- 
tase, but because the water can take up no more and has 
no further power as a media for the ferment. Pure 
alcohol in excess is a precipitant of pepsin, of albumen 
and of peptone. About 10 per cent, absolute alcohol dis- 
tinctly retards digestion in a test tube, but not because it 
is in this percentage injurious to the ferment. On the 
contrary, as already shown in the proportion of 15 to 20 
per cent, it affords a most valued preservative of infusion 
of the ferments. Other substances retard digestion sim- 
ply because they reduce or change the reaction of the 
media, as shown for example in peptic digestion by the 
fact that if the saturating powder of an added substance 
is compensated for by the addition of free acid to the 
percentage of the control, little or no retardation is found. 
The retarding influence of certain substances is modified 
by the strength of the digestive fluid — for instance, by 
the proportion of the pepsin to the albumen. If we take 
the utmost limit of albumen which a grain of pepsin can 
digest in several hours, say 2,000 grains, we shall find 
the digesting mass much more sensitive to salt, for 
instance, than one containing a grain of the same 
pepsin to 200 grains albumen ; the percentage of salt 
being the same in each case. This would seem to show 
that a powerful digestion is not affected like a feeble 
digestion — the retardation is relative not absolute. In 
the behavior of common salt in artificial peptic digestion, 
we have an illustration of the inadequacy of tests of 
" inhibitants " as guides to therapeutic uses of the 
digestive ferments or as explaining or approximating to 
the digestion in the body. Salt strongly retards the 



action of pepsin upon albumen in the test tube. It 
does not injure the ferment. On the contrary, it is 
a well known precipitant and preservative of pepsin. 
Salt inhibits digestion in a percentage which does 
not throw out the pepsin, nor affect the solvent 
action of water upon peptone, nor alter the reaction of 
the digesting mass. In view of these facts and of the 
universal use of salt as a condiment and antiseptic, we 
are at a loss to explain its retarding effects in artificial 
digestion and cannot believe it to exert any similar effect 
in the stomach. 

The stomach, moreover, is endowed with the power of 
maintaining the physiological conditions essential to diges- 
tion. The ingestion of an alkali may neutralise morbific 
acids and provoke the secretion of the acids of digestion. 
Acids form various combinations with proteids and bases 
of food substances. Substances may, like alcohol, retard 
digestion in a test tube, yet stimulate the secretions of the 
mucous membrane or be so rapidly absorbed as to have 
•but a passing effect in so far as they become a factor in 
the digestive process, or in altering either the composition 
or reactions of the digesting mass. In the medicinal use 
of the most pronounced retarding substances, they will 
seldom or never be so given as to impart to the digestive 
fluids the percentage which has been found inhibitory in 
the test tube. There are few soluble medicinal substances 
which, in some proportion, do not exhibit retarding action 
under test tube conditions. Experience, long in advance 
of these experiments in artificial digestion, has disclosed 
the disturbing effects upon digestion of both dietary and 
medicinal substances, due to conditions quite apart from 
those of the test tube, and in which these experiments 
afford but little practical significance. 



23 
INCOMPATIBLES. 

SUBSTANCES AND CONDITIONS WHICH DESTROY THE 
DIGESTIVE FERMENTS. 

It is remarkable that there exists so little difficulty 
in the practical use of the digestive ferments. It is not 
considered a hardship that nitrate of silver must be ex- 
cluded from light, or anaesthetics from evaporation ; or 
that hypodermic solutions must be freshly prepared. 
Whilst the incompatibility of drugs and chemicals extends 
to the formation of dangerous compounds from simple 
mixtures, the digestive ferments have practically but 
one sort of incompatibility to be avoided in dispen- 
ing or prescribing, that of substances or influences 
which render them inert. The manufacturer should 
not offer and the physician will not knowingly prescribe 
combinations, which are or are likely to become inert by 
the time they reach the patient's hands. Of all the con- 
ditions and substances with which the digestive ferments 
are brought into contact in their practical use, we may 
conveniently summarise those which render the ferment 
inert. 

A digestive ferment should never be mixed with water 
or any fluid of a higher temperature than can readily 
be borne by the mouth. In the peptonising process, in 
" sprays/' in " surgical solvents," too high temperature 
should be carefully avoided. Pepsin is destroyed in alka- 
line solutions — with lime water, sodium bicarbonate, 
aromatic spirits of ammonia, etc. All ferments in solution 
soon decompose unless in the presence of an antiseptic. 
Therefore, a mixture of trypsin, or pancreatic extract, 
water and soda can not be expected to keep indefinitely. 
The ferments should not be mixed undiluted with strong 
alcoholic tinctures, or astringents. Pancreatic ferments 
should not be placed in acid mixtures. Pepsin and pan- 



24 

creatic ferments should not be mixed together in solu- 
tions acid or alkaline. These mixed ferments can not 
be permanently held in an active form in any solution — 
elixir or whatever it may be called. 

In using a digestive ferment, it does not matter whether 
the ferment is in solution or suspended in a mixture ; 
whether the substance with which it is mixed is known 
to retard digestion in a test tube ; the main point is that 
the ferment shall not be destroyed — that it be exhibited 
in an active form. 



PEPSIN AND BISMUTH IN SOLUTION. 

Bismuth in solution is incompatible with pepsin. Pep- 
sin and the insoluble salts of bismuth, the subnitrate 
or the subcarbonate, is one of the most efficient and gen- 
erally used combinations. Obviously -these salts of bis- 
muth exert no influence upon pepsin in the dry state, nor 
are they injurious to the ferment when mixed with it in 
the fluid form. Therefore the bismuth subnitrate may be 
properly given, for instance, in Fairchild's Essence of 
Pepsine, or in the Glycerinum Pepticum. But the soluble 
salt of bismuth, the ammonia citrate, cannot be combined 
with pepsin in solution without rendering the ferment 
inert, as we pointed out ten years ago. This fact has 
been repeatedly adduced by pharmaceutical writers, and 
the elixirs of pepsin and bismuth have quite lost their 
vogue ; there is but a very limited demand for them. 
Before the digestive valuelessness of this pepsin and bis- 
muth elixir was known, the main attention of pharmacists 
was directed in the endeavor to overcome the chemical 
or pharmaceutical incompatibilities of this combination. 
This was due to the use of hydrochloric acid as a solvent, 
or to pepsin containing this acid, and the unstable solu- 



25 

tion of bismuth thus yielded in spite of the neutralisation 
with ammonia. Consequently we have advocated the 
employment of citric acid, which gives a satisfactory phar- 
maceutical preparation, and from time to time new formu- 
las for elixir of pepsin and bismuth appear. But however 
combined or skillfully prepared, it will be found that the 
bismuth in solution has rendered the ferment inert. The 
elixirs of pepsin and bismuth are invariably found upon 
assay to be completely devoid of any digestive action. 
The good they do is from the bismuth, alcohol, the 
aromatics, etc. Consequently this elixir of bismuth and 
pepsin should be discarded, and it is to be regretted 
that it has found a place in any " formulas," and thus 
encouragement given to a palpably improper combina- 
tion. 

ANTISEPTICS. 

The influence of antiseptics upon the digestive ferments 
is of great practical importance. Alcohol, glycerin and 
common salt are the most available technically — both in 
the pharmaceutical preparations of the digestive ferments 
and the preservation of solutions of peptonised products. 
Brine extracts the rennet and some of the pancreatic fer- 
ments. Other antiseptics, borax, boracic acid, salicylic acid, 
thymol, etc., render infusions of the ferments stable. But 
this class of antiseptics should not be resorted to, for every- 
where in food stuffs, beverages, etc., they are distrusted and 
not permitted as a substitute for alcohol. They are not 
permissible unless directed by the physician There are 
antiseptics which may be so freely used in a digesting 
mass as to prevent all ulterior or putrefactive changes 
and yet not interfere with the action of the digestive 
ferments. Creosote is remarkable for this property 
and when introduced in the pancreatic digestion of milk, 



26 

fibrin, etc., the usual digestive transformation takes place 
without the occurence of fermentative changes, even after 
many hours. Pure creosote is therefore justly regarded 
as a most valuable medicinal antiseptic to prevent fermen- 
tative changes, especially in the intestinal tract. 

"JUMBLES." 

There are a certain class of digestive compounds 
which have been aptly characterised and condemned by 
Fothergill as unscientific "jumbles." There is an objection 
to these jumbles more serious than any based upon theory 
as to the propriety of mixing up all the agents of diges- 
tion with acids and milk sugar. Indeed, there has never 
been any conclusive argument against efficient combina- 
tions of the various ferments, and many physicians employ 
tablets of " Fairchild's " Pepsin and Pancreatic Extract. 
So whatever our theory about digestive compounds, 
certainly a compound can be judged only by its actual 
digestive value, just as we judge or value the single fer- 
ments. Nothing can be easier than to triturate powders 
of pepsin and pancreatic ferments, and such a mixture 
will exhibit all the properties of each one of the fer- 
ments. Notwithstanding this, most of these compounds, 
"pepsin, pancreatine, diastase and acids," do not contain 
any other ferment besides pepsin ; consequently there 
can be no escape from the conclusion that their value 
as remedies depends solely on the pepsin and acid they 
contain. Such compounds have been again and again 
condemned for their defective and deceptive character by 
competent medical and pharmaceutical writers. There is a 
fallacy that is fast being ventilated, in the pretence that 
such compounds possess peculiar remedial or "clinical" 
value, in spite of their failure to show digestive action. The 
use of these compounds is one of the strongest evidences 
of the value of pepsin, even when diluted with milk sugar. 



27 

VEGETABLE FERMENT. 

The property of certain vegetable "milk juices," of 
softening or liquefying fibrin and albumen, has long been 
known. It has been of speculative interest to the botanist 
and physiologist ; but these exceptional instances of the 
presence in plants of a proteolytic ferment of no discover- 
able relation to their nutrition is without physiological 
significance. It is of practical import to the physician 
only to the extent in which these vegetable substances 
may prove to possess any superiority to the animal 
proteolytic ferments. These vegetable principles have 
been the subject of considerable experiment in various 
quarters without the appearance, to our knowledge, of any 
data showing their especial utility or availability. On 
the contrary, they have been deemed far weaker than the 
animal ferments. In order to ascertain for ourselves the 
properties and comparative value of the vegetable prod- 
ucts we, years ago, obtained specimens of dried milk 
juice, and the so-called active principles thereof, and sub- 
jected them to assay in acidulated water, under the usual 
range of conditions competent for pepsin, and with 
alkaline and neutral water, under the conditions suitable 
for pancreatic extract. Subsequently we have, from time 
to time, tested specimens submitted to us by parties pro- 
posing to introduce the vegetable product on the market. 
Again recently, our attention has been brought to the 
subject, and we have repeated careful tests of the vegeta- 
ble ferments as found in the market. As a result of these 
many tests, we have invariably found all specimens, papa- 
yotin, papaine, papoid, etc., of such very slight activity in 
comparison with either pepsin or pancreatic extract, that 
we have always declined to introduce the vegetable prod- 
uct, and have never found reason to undertake its manu- 
facture. The vegetable ferment exhibitits no new, peculiar 



28 

or superior property either as regards media or character of 
action. Considered as a "vegetable pepsin," its value must 
rest upon its action in acidulated water, for pepsin has no 
action except in acid ; here papayotin or papoid is prac- 
tically inert. Considered as a ferment capable of action 
comparable with trypsin, its value must rest on its action in 
neutral or alkaline media ; here it is of very feeble 
power. As a peptoniser of beef, fibrin, egg albumen or 
milk, its action is so slight and unsatisfactory as to be of 
no practical utility. The claims advertised, that a cer- 
tain vegetable product acts in acid or alkali, in " less 
water " are simply preposterous. Water is essential to all 
physiological action. The simplest tests under various 
ranges of acidity, alkalinity, all ranges of temperature, of 
proportions of water, will at once show that the " vegeta- 
ble " ferment possesses no immunity from the conditions 
governing all ferment action. The most remarkable thing 
about the "vegetable pepsin" is that its value is in an 
inverse ratio to the claims made for it, and the prices 
asked for it. 

THE GASTRIC FERMENTS. 

PEPSIN. 

Pepsin, the peculiar digestive principle of the stomach, 
is active only in the presence of an acid, and most potent 
with the acid of normal gastric juice and with the percent- 
age of free acid present at the height of gastric 
digestion. Its action is, however, by no means in- 
separably associated with hydrochloric acid, but it acts 
freely with a wide range of acidity with both mineral 
and organic acids, lactic, tartaric, etc. Even the faintest 
acidity is sufficient to call forth its action, which is 
not greatly modified at points either slightly above or 
below the free acid of the normal media. Pepsin digests 
but one form of substance, proteids, all forms of which 



29 

it is capable of converting into peptone. Various forms of 
proteids show some varying behavior under the influence of 
the artificial gastric juice. Coagulated egg albumen goes 
into solution from the surface gradually and only upon 
prolonged contact does the excess of albumen show any 
notable softening effects or gelatinous appearance. Raw 
fibrin or fresh meat, instantly swells in contact with acidu- 
lated water, and then undergoes softening and solution. 
Boiled fibrin or flesh behaves like boiled egg albumen. If, 
however, the raw albumen has been previously dissolved in 
water and then boiled, we obtain a gelatinous or mucilagi- 
nous albumen, which upon contact with the active ferment 
almost instantly becomes thinner and soon goes into com- 
plete solution. The ferment here behaves almost identi- 
cally as does diastase with gelatinous starch, and the 
resulting solution will contain various forms of soluble 
albumen and peptone, just as the starch solution will 
contain soluble starch and dextrin. The peptic digestion 
of albumen is a gradual, progressive transformation into 
peptone, with various intermediate forms of soluble albu- 
men, the percentage of peptone depending greatly upon 
the proportion of ferment to the albumen and the duration 
of the digestion. Gastric digestion ceases at peptone ; 
there is no further change or splitting up of the peptones 
as in the case of pancreatic digestion. Pepsin is not only 
inert in alkaline solutions, but is destroyed with merely 
sufficient alkali (such as for instance, sodium bicarbonate,) 
to give an alkaline reaction. It is not possible by subse- 
quent acidulation or any treatment, to bring the ferment 
to show the slightest activity. 

PEPSIN, ITS PRACTICAL USES. 

Pepsin is not available for peptonising food for the 
sick, in the household. Its action is not only restricted to 



30 

albuminous substances, but acid being indespensible, the 
product is for this reason unsuitable as a food. In the 
laboratory this ferment may be and is comnionly utilised, 
for there the acids are separated and the products clarified, 
properly. But the terms " peptonised " and peptone are so 
fixed in the popular mind in association with pepsin, that 
many continue to regard a peptonised food as one made 
with pepsin or containing pepsin. Pepsin is useless in tjie 
artificial digestion of milk. Pepsin cannot be used for the 
artificial digestion of food at the table in the way that the 
Extractum Pancreatis may be. Pepsin is, however, useful 
for the solution of fibrinous membrane, coagula, etc., and is 
much employed as a surgical resource. For its use in this 
direction, see " Surgical Use of the Digestive Ferments/' 
The exhibition of acid in conjunction with pepsin depends 
much on circumstances, for it cannot by any means be 
held to be always indispensable. Normal gastric juice 
contains both free acid and pepsin. An artificial gastric 
juice for digestion in a flask, can only be obtained by com- 
bining these two agents. But the stomach cannot be dealt 
with as with a beaker glass. We see the good effects from 
the administration of pepsin without acid or in such faintly 
acid solutions as Fairchild's Essence of Pepsine. If a 
physician sees indication for the administration of soda, as 
in acidity of the stomach, and for pepsin to aid digestion, 
these two remedies may be combined dry without regard 
to the fact that in an alkaline solution pepsin is inert. For 
it is not supposable that an amount of soda sufficient to 
impart an alkaline reaction to the entire gastric contents 
would ever be given. 

MILK CURDLING FERMENT OF THE 
GASTRIC JUICE. 

The gastric juice contains a distinct principle which has 
the power of curdling or coagulating milk, It is not known 



31 

to have any other property ; consequently it cannot be con- 
sidered a digestive ferment in the sense that it effects any 
change in the constitution of an alimentary substance. 
Whilst many studies have been made and theories advanced 
concerning the action of this ferment, of the changes milk 
undergoes in coagulation by it, we can only say of this 
ferment as of others, we do not know how it acts ; we know 
it to be a true ferment. A solution of this ferment heated 
to 170 instantly loses all activity. Its action is not, like that 
of pepsin ferment, dependent upon the intervention of an 
acid. It curdles neutral or even faintly alkaline milk. It may, 
like pepsin, be extracted by acidulated water. Therefore, we 
may obtain both ferments in an active, permanent solution. 
In remarkable contrast to pepsin it is not precipitated by 
common salt. A brine extract is commonly employed in 
the use of " rennet " in cheese making. These salt infusions 
of the rennet are devoid of all peptic activity. Pepsin has 
no curdling property, and whatever milk curdling action a 
preparation of pepsin may show is due entirely to the 
true curdling ferment associated with it. Notwithstand- 
ing this fact, the impression still obtains that pepsin should 
curdle milk. The question has been raised as to the value 
or function of this ferment in the natural process of diges- 
tion, seeing that the gastric juice contains acid which 
itself, it is said, should coagulate milk. But it is a fact that 
milk does not by any means behave with acid precisely as 
with the curdling ferment ; in the one it is entirely a chem- 
ical change, in the other a physiological change wrought 
instantly, and accompanied by no change in the chemical 
constitution of the caseine. Further it is of great signifi- 
cance, it seems to us, to find that this ferment exists in the 
greatest activity in the stomach of the suckling animal. 
This is so well known, that it is always the " milk rennet " 
which is used from which to prepare rennet liquids. The 
stomach of the hog contains but a trace of the ferment, and 



32 

pure pepsin from this source is invariably useless for 
curdling milk. It would, therefore, seem quite likely that 
this ferment plays no insignificant part in the digestion of 
milk. By its action the caseine is thrown out in the form of 
coagula, most susceptible to the action of the gastric juice, 
whilst the whey, containing the salts and milk sugar and 
the soluble forms of albuminoid, passes freely along the 
digestive tract, where it undergoes assimilation without the 
need of any digestive action. In the young suckling, fur- 
thermore, the pancreas is but partially developed. In this 
curdled milk, we see that the caseine is reduced to a con- 
dition analogous to that in which the flesh foods of the 
adult are presented to the stomach. If the milk were not 
curdled, either by acid or rennet, certainly there would be 
no obstacle to the free passage of the fluid milk along 
the infant's digestive tract. It is not, then, without pur- 
pose, this curdling ferment in the stomach of the suckling 
animal. 

The liquid rennets of the shops prepared from salted 
vinous menstruum do not contain pepsin and have been so 
inferior and variable in curdling activity that they have 
fallen into disuse. 



THE PANCREATIC FERMENTS. 

TRYPSIN. 
THE PROTEOLYTIC FERMENT OF THE PANCREAS. 

The pancreas juice contains a principle which may be 
said to be the analogue of pepsin, in that it is capable of 
converting all forms of proteids into peptone. It differs 
markedly from pepsin in important particulars. Whilst it 
is most active in an alkaline solution, it is also energetic in 
a neutral solution, and digests milk freely without addi- 
tion of alkali. Thus, it is not restricted in its media to the 



33 

reaction characteristic of the fresh pancreas juice, having 
on the contrary, as will be seen, a wide range of action. 
Whilst in a feebly acid solution, especially with organic 
acids, it is found to exhibit action upon fibrin and albumen, 
free hydrochloric acid is far from being favorable to tryptic 
action. 

Trypsin yields various soluble products and peptones 
which do not materially differ from those of peptic diges- 
tion, but unlike pepsin it gives still further normal prod- 
ucts by the transformation of peptone into leucin and 
tyrosin. 

Trypsin has a special affinity for the proteids of milk, 
showing proportionately more activity upon caseine than 
upon other proteids. In the Extractum Pancreatis, trypsin 
is presented as naturally associated with the other fer- 
ments of the gland. We have also made a special prepar- 
ation of trypsin as a solvent for diptheritic membrane. 



THE DIASTASE OF THE PANCREAS. 

The starch digesting principle of the pancreatic juice 
presents no known difference from the ferment of the 
saliva, or of germinating grain (malt) in the media or 
method of its action, or in the result of its action. Like 
every known form of diastase, it gradually converts gelati- 
nous starch into soluble starch, dextrines, glucose or malt 
sugar. It is active in neutral or alkaline reactions. We 
cannot therefore, distinguish one form of diastase from 
another merely by its behavior, and whatever views may 
be held regarding diastase as a remedy, must apply to 
this ferment from whatever source it appears. We have 
no means of knowing definitely to what degree of con- 
version starch is carried in the natural process of diges- 



34 

tion, but there is no doubt that its complete transfor- 
mation into glucose is not essential to its assimilation ; 
physiological experiments show that the highly diffusible 
dextrines and soluble starches are absorbed into the 
blood, and there is every ground to suppose that a very 
considerable portion of the products of starch digestion 
are absorbed long before they could reach their ultimate 
conversion. The influences of various substances upon 
diastase are, as in the case of all ferments, largely mod- 
ified by the proportion of ferment and by the presence of 
products of digestion, etc., so that, whilst in the labora- 
tory we fix the retarding influence of definite percentages 
of acids or of alkali under arbitrary conditions, we must 
not overlook the insufficiency of such data as bearing upon 
the actual conditions of digestion within the body. 

The incompatibility of acid and diastase does not afford 
sufficient ground for the assumption that the starch digest- 
ing principle finds no field for action in the stomach. The 
gastric juice is absolutely inert upon starch ; the major 
part of farinaceous matter is in a form incapable of solu- 
tion during the short contact with the salivary diastase in 
the mouth ; the stomach contents have at the outset of 
normal digestion but a feebly acid reaction, and the acidity 
only reaches its maximum point an hour or so after the 
ingestion of food. In view of all these facts, the conclu- 
sion is reasonable, that the stomach affords opportunity for 
such preliminary digestion of starch as fits it for further 
conversion in the intestinal tract. 



USES OF PANCREATIC DIASTASE. 

The practical identity of the pancreatic and salivary 
diastase being established, it follows that we may as 
reasonably exhibit an active extract of the pancreas in 



85 

deficiency of salivary digestion, as we may exhibit pepsin 
in feeble gastric digestion. 

The most rational way of supplementing deficient sali- 
vary digestion is to add the active pancreatic preparation 
to farinaceous food at the table. No taste is imparted to 
the food, no suggestion whatever of " medicine," and under 
its influence the starch is rapidly softened, and converted 
into a soluble form which will insure its proper digestion. 
For children and the aged and convalescent, this method is 
especially recommended. For faulty intestinal digestion of 
starch, the Extractum Pancreatis or DiastasicEssence should 
be given immediately after meals, and repeated in an hour 
or two. In the Extractum Pancreatis the starch digesting 
principle is accompanied with ferments which digest all 
other forms of aliment, and which are often indicated in 
connection with diastase. In the Diastasic Essence of 
Pancreas, the starch digesting principle is presented in 
an exceedingly active, agreeable and practically isolated 
form, and it, therefore, may be advantageously resorted to 
in cases where it is not desired to adminster the other fer- 
ments of digestion. For intestinal indigestion of starch, the 
diastasic ferment may best be given just previous to taking 
food, and again about two hours after food. The diastasic 
ferment given just previous to or with meals promotes 
the preliminary starch digestion, that which is normally 
effected by the salivary diastase ; given after the force 
of gastric digestion is lessened, it promotes the secondary 
or pancreatic digestion of starch. The Pancreatic Tab- 
lets and the Diastasic Essence are especially commended 
as a means of exhibiting this ferment. 

THE EMULSIVE FERMENT. 

The characteristic action of the emulsive ferment is the 
conversion of oils or fats into a minute statp of division or 



36 

emulsification. The emulsification and absorption of the 
minute divided molecules are successive steps, precisely as 
the conversion or hydration of albumen is antecedent to its 
absorption. Whether there is also any chemical change in 
the fat by action of the ferment, may be said to be a moot 
question. If a fat or oil is macerated for some hours at 
the temperature of the body with fresh pancreas juice or 
with minced pancreas and then strained, it will be found 
that the pancreatised fat will instantly form a thick, creamy 
emulsion when shaken with an equal quantity of water. 
The pancreatic j uice when taken from the gland soon under- 
goes change and shows an acid reaction, and it has been 
asserted that when the development of these fatty acids is 
prevented, there is no occurence of these acids in the 
treatment of fat under the influence of the emulsive fer- 
ment. As the chief and characteristic behavior is the 
breaking up of the fat into emulsion or creamy form, 
so doubtless is the greater part of fat assimilated 
direct without undergoing any conversion . It is a 
curious fact that this, the least available and the least 
practically important pancreas ferment, has been the 
one to which attention had been chiefly directed prior 
to the introduction of the Extractum Pancreatis. 
The " pancreatines " found in commerce bore no 
other reference to any digestive action or use than 
their asserted property of emulsifying cod liver oil, 
whilst they were completely deficient in the other fer- 
ments of the gland. The emulsive ferment is not 
capable of effecting the permanent admixture of oil 
with water, as may be done by purely mechanical 
agents, such as gums, etc. The pancreatic liquors, 
as well as the commercial pancreatine, are of only 
the slightest emulsive value. The Extractum Pan- 
creatis is in this, as in other ferments of the gland, 



Oi 

the most active product. If a few grains of the Ex- 
tractum Pancreatis be well shaken with one or two 
drachms of warm water, and an ounce of cod liver oil or 
pure olive oil, and allowed to stand in a warm place for 
five or six hours, it will be found that this oil will then 
form a creamy emulsion with water ; upon standing, this 
emulsion will gradually separate, but may again be emul- 
sified by agitation. When the use of the gummy and 
starchy, sweet emulsions are contra-indicated, The Ex- 
tractum Pancreatis may be utilised as already described, 
or it may be given immediately after the pure oil or the 
usual emulsions. 

THE MILK CURDLING FERMENT OF THE 
PANCREAS. 

The pancreas contains a ferment which curdles milk 
slightly acid, neutral or alkaline. As associated with the 
other ferments of the pancreatic juice or in an active 
extract of the pancreas, such as Fairchild's Extractum 
Pancreatis, it cannot be practically utilised in the same 
manner as the rennet ferment in the preparation of curds 
and whey. 

The proteolytic ferment will attack the curded caseine 
and soon dissolve it. If a few (five) grains of Extractum 
Pancreatis be added to pure lukewarm milk, (say four 
ounces) a soft curd will be almost instantly formed. If 
the milk is permitted to stand at rest, the curd will not 
cohere and separate in a mass from the whey as in rennet 
curdling, but will gradually become softer, will float in 
the milk and finally disappear. If the milk is stirred 
with a rod or spoon, the curd is instantly broken up into 
minute particles, blended with the milk and soon under- 



38 

goes digestion, the milk acquiring the characteristic color 
and taste of peptonisation. 

THE DOSAGE OF DIGESTIVE FERMENTS. 

The digestive ferments having no drug action, no 
property comparable to that by which the doses of 
remedial agents are in general regulated, a small dose 
differs from a large dose only in degree, not in character of 
effect produced. There is no such relation of effect to dose 
as in the case of drugs, such as ipecac, calomel, strych- 
nine, etc. We cannot expect, therefore, to fix any 
arbitrary range of dose as with drugs with distinct 
measurable action upon the body. In the days of the 
saccharated pepsins and pancreatines, large bulk with minute 
quantities of true ferment were given ; with the introduc- 
tion of Fairchild's preparations of unprecedented activity, a 
few grains became the generally employed dose, and the 
tendency seems to be, as these products are more and 
more improved in potency, that the doses are rather dimin- 
ished. Doubtless there has obtained in the past some 
impression that large doses of pure ferments might not be 
harmless ; but neither in medical literature nor in anything 
that we know of the physiology of digestion, nor from the 
extended opportunity for learning the results of the practi- 
cal use of the digestive ferments, does there appear any 
tenable ground for this assumption. It has existed only 
as a vague theory, and as a surmise of possibilities. The 
animal digestive ferments find a place in materia medica, 
because they display upon food substances under con- 
ditions closely conformable in temperature and in reaction 
to those of the body, the action characteristic of the normal 
digestive secretions. Properly introduced into the living 
digestive tract, we may then expect that they will exert 
precisely the same effects as the naturally secreted 



39 

ferment. A large dose of pepsin artificially introduced 
into the process of digestion can no more attack the 
stomach membrane than will the natural gastric juice. 
The sufficient dose to supplement deficient digestion 
must vary largely and the dose need only be reg- 
ulated by considerations of the amount required to effect 
the purpose. That habitual use of a ferment may rationally 
be resorted to, in order to produce tranquil digestion for 
those patients whose digestion is susceptible to disorder, or 
impaired by care, anxiety and sedentary occupation and 
similiar influnces is beyond question. What expedient 
more practical or innocent ? Certainly far less likely to be 
harmful, than persistent " drugging." 

THE FAIRCHILD PREPARATIONS 

OF THE 

DIGESTIVE FERMENTS. 

The uniform character, activity and reputation, of 
the Fairchild Preparations of Digestive Ferments are 
sufficient evidence, of the fallacy of the statements 
sometimes advanced, that the digestive ferments are 
necessarily variable and unreliable agents. The fact 
is that Fairchild's digestive ferments are second only 
in uniformity to the alkaloids and chemicals. They 
are more definite and uniformly reliable than most 
drugs, or galenical preparations therefrom, — extracts, 
tinctures, etc. The status of these preparations of the 
digestive ferments, moreover, does not depend simply 
upon medicinal properties, so difficult to determine for 
all agents except those which have a distinct action upon 
the body. They are valued for reason of definite 
demonstrated and applied digestive properties. 



40 

The Fairchild special products have been put for- 
ward with definite methods for accomplishing certain 
practical results. As a record of more than ten years of 
experience, not an instance has occured where one of our 
preparations has failed to perform this work — has disap- 
pointed the anticipation of the physician. Not a package 
of the Extractum Pancreatis nor a Peptonising Tube has 
proven inert upon milk or starch. The surgeon who sees 
the potent solvent action of Fairchild's pepsin upon 
morbid tissue ; the physician who sees the absolute 
certainty with which the Extractum Pancreatis may 
be applied in peptonising milk, etc., will not doubt these 
agents possess substantial claims to therapeutic use. 

The Fairchild preparations are the result of original 
special work given to the digestive ferments. Each and 
every product offered to the medical profession has been 
carefully prepared to meet certain requirements and to 
fulfill a definite purpose. 

We have especially sought to avoid all incompatible 
compounds, and do not supply these even if having popu- 
lar sale, and do not needlessly multiply the variety of 
preparations. For all the important purposes for which 
the digestive ferments are now applied, the Fairchild 
preparations have been either originated, or been the 
means employed, on account of their well-known 
superiority. 

The commercial products will differ in character, 
in grade of activity, in purity according to the skill 
knowledge and purpose of the manufacturer. Some are 
made to supply a demand for cheap preparations ; others 
to imitate in physical characteristics products which have 
become eminent for value. 



41 

The Fairchild preparations being almost exclusively 
dispensed upon the prescription of the physicians, we 
have with a due regard to the interest and convenience of 
the pharmacist, supplied them in bulk whenever practica- 
ble. This fact has, however, only afforded better oppor- 
tunities to that class of manufacturers who find it 
impossible to make a market for their goods on the score 
of merit, but who, as in every " line," prefer to trade 
upon the reputation of standard products by the substitu- 
tion of inferior and " cheap " imitations. These inferior 
products are urged upon the pharmacists as the " same 
thing," " gives you extra profit ;" if " Fairchild's is not 
specified, use ours ;" although it is plain that the physi- 
cian even when not specifying Fairchild's really means 
and expects to get Fairchild's, owing to his long reliance 
upon them years before the appearance of so many prepa- 
rations under the same titles. 

Owing to the great reputation and use of Fairchild's 
Essence of Pepsine, this preparation has been the especial 
object of imitation. 

The title, Essence of Pepsin, has been applied to 
preparations entirely dissimilar and inferior in properties 
to the original Essence of Pepsine. 

In many instances, upon complaint of physicians, we 
have examined these dishonest imitations which have 
been substituted even when Fairchild's is specified, and 
found them often inert upon milk, of weak peptic power 
and of a distinctly unpalatable character. In view of the 
very important properties and uses of this Essence as a 
means of administering drugs, preparing whey, etc., to 
correct digestive disorders of infancy, the substitution 
of these worse than useless preparations inflicts serious in- 
jury — injury upon the patient, the physician, and the 



42 

manufacturer upon whom the physician relies. Further 
the same price is charged the customer as for the original 
article — which leaves no question as to the real purpose 
of this infamous practice. We desire to take this occasion 
to say that in contrast to this, the great body of pharma- 
cists not only religiously regard the wishes of the pre- 
scriber, but many of them, we are glad to know dispense, 
and use generally, Fairchild's preparations by their own 
preference. Seeking no other market than that caused 
by the preference for Fairchild's preparations, we desire to 
protect ourselves, the physician and his patient, from the 
substitutes and imitations. We, therefore, ask the favor, 
that the physician will distinctly specify Fairchild's when 
he wishes them, and in case of any dissatisfaction that he 
will send to us for examination the preparation dispensed. 

FAIRCHILD'S 
PEPSIN IN SCALES AND POWDER. 

Pepsin in Scales, " free from all added substances," 
was originated by Fairchild Bros. This, the first pep- 
sin in scales, was vastly in advance of the commercial 
products then in the market, and for some years 
it was the only pepsin known in the form of scales and 
by this title. But the reputation and use it obtained 
ultimately invited the inevitable imitations of name and 
appearance. The poor quality of many of these made it 
plain that they were made to supply the demand for pep- 
sin in scales. That the reputation and value which became 
attached to the product and the name " pepsin in scales," 
are due to the quality of the original Fairchild's Pepsin 
in Scales, is beyond question. It has always possessed 
the two essential qualities of dry pepsin — activity and 



43 

permanency. Fairchild's pepsin is just as permanent in 
powder as in scales. The powder is simply the powdered 
scales. The powdered peptone products are very suscep- 
tible to moisture. Fairchild's pepsin is especially suitable 
for dispensing in powders, capsules, etc. It will not be- 
come sticky, even in damp climates — will not gum up in 
the powder papers, either pure or mixed with bismuth^ 
soda, etc. One grain of Fairchild's pepsin will digest 2,500 
grains egg albumen in six hours at 105 F. 

SACCHARATED PEPSIN. 

This, the only officinal form of dry pepsin; is conven- 
ient for those who wish to prescribe pepsin in very small 
doses, as for infants. But its digestive standard is so 
weak that there appears little use for a saccharated 
product, in any case where it is at all practicable to mix the 
pepsin and milk sugar in whatever proportion desired by 
the prescriber. The officinal saccharated pepsin repre- 
sents about two and one-half per cent, of 1 to 2,000 
pepsin, about 98 per cent, milk sugar, thus but a minute 
quantity of actual ferment in a dose of practicable bulk. 
Further, when a physician prescribes pepsin without 
specifying which product desired, the druggist must try 
to decide whether " pure 5 ' or saccharated is required, or 
simply dispense the officinal. Most of the " saccharated " 
sold does not even conform to the U. S. P. standard, which 
requires 1 grain to digest 50 grains egg albumen. 

GLYCERINUM PEPTICUM. 

(fairchild.) 

Glycerin possesses peculiar value as at once an extrac- 
tive and preservative of the digestive ferments. For this 
purpose it has long been used in the physiological labora- 



44 

tory and the glycerin extracts have been preferred for ex- 
perimental purposes. Fairchild's Glycerinum Pepticum is 
the first commercial product in which glycerin has 
been utilised to prepare a concentrated, stable solution of 
pepsin, direct from the mucous membrane. This Glyceri- 
num Pepticum presents the peptic ferment in the most 
isolated form in which it has ever been produced in solu- 
tion for practical purposes, containing no alcohol, sugar, 
flavoring or antiseptic other than the pure glycerin. It is 
a clear, bright extract, remarkably free from color, odor 
or taste, freely soluble without cloudiness in ail proper 
menstrua or media. It is notably devoid of the peculiar 
disagreeable characteristics of the glyceroles of peptone 
pepsin. It is by far the most convenient and useful for 
all purposes where pure pepsin is required in solution ; for 
extemporaneous mixtures, for experimental purposes, for 
applying pepsin as a surgical solvent, for preparing officii 
nal solutions. It is quite agreeable, even in pure or acidu= 
lated water and may be given in wines, elixirs, etc. It 
is especially convenient for the physician who finds it 
desirable to dispense medicines and for hospitals and 
dispensaries. For the manufacture of all the usual pep- 
sin fluids, wines, elixirs, liquors, etc., it is far preferable, 
gives a more stable and agreeable preparation than ob- 
tainable by any other form of soluble pepsin. Twelve 
minims are capable of digesting 2,000 grains albumen 
under usual conditions. 

In Fairchild's pepsin in scales or powder and in Fair- 
child's Glycerinum Pepticum, the physician and the 
pharmacist have the dry and soluble ferment in the most 
convenient and desirable forms, covering all possible 
uses of the concentrated pepsin. The peptone-pepsins 
have never filled both purposes of perfect solubility and 
resistance to moisture. 



45 

ESSENCE OF PEPSINE. 

(fairchild.) 

a solution of the essential organic ingredients of 
the gastric juice, extracted directly from 

THE PEPTIC GLANDS OF THE STOMACH. 

Fairchild's Essence of Pepsine is obtained by direct 
extraction from the fresh calf rennet in a menstruum 
which possesses, in the highest degree, the properties of a 
vehicle and a preservative of the peptic and the milk 
curdling ferment. 

The Essence of Pepsine is a remarkably agreeable, 
diffusible, aromatic stimulant ; yet holds in solution both 
the active ferments of the fresh gastric juice. It is but 
faintly acid, not in the least heavy with sweet, leaves upon 
the palate not the least pronounced impression of any pre- 
dominant flavoring. It is free from all suggestion of 
animal origin, and further, imparts a delicate flavor and 
aroma to milk-curd or junket, whey and cold milk, 

Pepsin, like many another remedy, gains by judicious 
association of corrigents, and only second to the actual 
agents of digestion are the aromatics skillfully combined. 
It is a matter of common experience, even in health as to 
the influence of savory substances, and of the remarkably 
malevolent effect of some discordant flavor ; and dyspeptics 
are especially sensitive to digestive disturbances out of all 
proportion to the apparent cause. The usual pharma- 
ceutical preparations, the elixirs, wines, cordials, and so 
forth, are generally poor examples of what a blend of 
proper aromatics should be. Many of these preparations, 
produced in imitation of Fairchild's Essence, are so dis- 
tasteful as to greatly militate against the good effects which 
might be derived from any ferment they may contain. 

Fairchild's Essence of Pepsine has long been the most 



46 

useful and successful of all pepsin preparations. It is 
found of peculiar value for three distinct purposes — as a 
remedy for indigestion in adults and infants ; as a means 
of administering drugs which disturb the digestive func- 
tions and impair the appetite ; as a practical rennet agent. 

For infantile digestive disorders Fairchild's Essence of 
Pepsine is especially effective ; it not only aids digestion, 
but corrects flatulency and vomiting. It is, therefore, 
far more innocent and effective than the usual domestic 
and empirical remedies for colic, etc. ; certainly in- 
finitely preferable to soothing cordials. In cholera infantum 
it presents the most valuable properties — stimulant, car- 
minative, and digestive, and is far better than alcoholic 
stimulants, per se. For persons of habitually weak diges- 
tion it proves the most acceptable and potent resource. 

The usual dose for an infant is from 5 to 10 drops, and 
from 1 to 3 teaspoonfuls for an adult. 

That Essence of Pepsine is of great service in aiding 
the tolerance of drugs such as iodides, bromides, mercur- 
ials, etc., is well known. Here it is not only important to 
give pepsin, but the ferment must be in such a form as to 
overcome the repulsion caused by the ingestion of these 
drugs. The Essence of Pepsine has proven of the greatest 
possible service in the administration of such drugs, be- 
cause of its digestive and grateful stomachic properties. 
It is confidently relied upon for this purpose by many phy- 
sicians. As a vehicle simply, the Essence is by far the 
best in use. Drugs which give unsightly mixtures or 
which completely overcome the agreeable qualities of the 
Essence should be given in separate form, to be immedi- 
ately followed by one or two teaspoonfuls of the pure 
Essence, thus gaining the greatest advantage of its 
agreeable qualities. 

The efficacy of the Fairchild's Essence for administering 



47 

iodide of potash and the certainty with which the Essence 
is used in making milk curd or junket, has led to the suc- 
cessful experiment of using this essence junket itself as a 
vehicle for the iodide of potash. The method of preparing 
this medicated junket is given on page 45. 

Further practical uses of Essence of Pepsine in prepar- 
ing whey, junket, etc., as food for invalids and in cholera 
infantum, are given in Practical Recipes. 

Fairchild's Essence of Pepsine was the first medicinal 
preparation ever offered of the two gastric ferments, pepsin 
and milk curdling. Such a pharmaceutical product from 
the fresh stomachs has only been obtained by many years 
of experience and skill, and utmost care and nicety in 
manipulation. 

The wine and elixir of pepsin obtained as they have 
been, by dissolving absurdly small proportions of sacchar- 
ated or other pig pepsins in wine, etc., are practically use- 
less. The more recent class of " essences," etc., made in 
imitation of Fairchild's, to fill the prescriptions for Essence 
where Fairchild's is not actually specified, are greatly 
inferior in every respect to the original Essence of Pepsine. 
They are obviously made from peptone pepsins dissolved 
in " elixir bodies," are inferior in every important respect, 
quality, flavor, pepsin and rennet action. Many physicians 
who have for ten years and more used Fairchild's Essence, 
naturally expect this will be dispensed when they order 
Essence of Pepsine, but it is now very important to specify 
Fairchild's. The substitutes cost the patient the same price 
as the genuine. 

MEDICATED JUNKET. 

JUNKET WITH POTASSIUM IODIDE, MERCURIALS, ETC. 

The use of junket as a vehicle for the exhibition of 
iodide of potash was first suggested by Dr. D B Bryson 



48 

Delavan of New York, in a paper which appeared in the 
New York Medical Record, Nov. 28th, 1891. Dr. Dela- 
van found by dissolving the iodide in Fairchild's Essence 
of Pepsine, and adding this to a small quantity of warm 
milk, that the curd which was instantly formed completely 
enveloped the salt in a thoroughly diffused form, and gave 
no taste or suggestion of its presence. It was found by 
this writer that the iodide could thus be freely adminis- 
tered without the disturbance of digestion so character- 
istic of this most distinctly repulsive chemical. 

Subsequently we tried Fairchild's Essence of Pepsine, 
used in the manner suggested, in preparing junket with 
Potassium Bromide, Sodium Salicylate, Iodide of Potash 
with Biniodide Mercury, Chloral Hydrate, etc., and with all 
these found the Essence to at once yield an agreeable, 
jelly-like curd. We have in this junket, as prepared with 
Fairchild's Essence of Pepsine, a distinct acquisition to our 
means of administering a class of drugs which it is of the 
utmost importance to be able to give in a form which does 
not disturb the stomach. Wherever it is desirable, this 
junket may be used to convey the iodide, mercurials, etc., 
without the knowledge of the patient as to its medicinal 
character. This is the formula best adapted for prescrip- 
tion : 

^ Potassium Iodide f 3 ii. 

Essence of Pepsine, Fairchild's f 5 iii. 

Add one teaspoonful to a wine-glass of warm milk, and 
take the resulting curd (after meals, or at such times as 
desired to order it). From 5 to 10 grains Salicylate Soda, 
or Potassium Iodide, with ^ to \ grain Mercury Biniodide, 
may be ordered to each fluid drachm of the Fairchild's 
Essence. 

PEPSIN TESTING. 

Notwithstanding the immense study which has been 
given to pepsin, no satisfactory chemical test for it has 



id 

ever been established. The more we learn about the 
digestive ferments, the stronger becomes the conclusion 
that they are all some form of albuminoid matter, as they 
are themselves the product of albuminoid cells. A chem- 
ical test for pepsin must be one very sharply distinguished 
from all other reaction of albuminoids; must be the unmis- 
takable evidence of the living ferment. For a ferment 
may have been subjected to influences which may have 
quite destroyed its activity and not appreciably altered its 
physical or chemical characteristics. Whilst we may dis- 
cover some peculiar reaction for pepsin, it is scarcely 
possible that we can ever assay pepsin by chemical analysis. 
As pepsin appears in commerce., the ferment is associated 
with substances readily distinguished, such as common salt, 
milk sugar, hydrochloric acid and starch. If these are in 
obviously large proportion, the inference will be that the 
products are weak, yet this is by no means certain, for a 
saccharated pepsin may prove more active than a so-called 
M pure pepsin/' in which the ferment is either injured in the 
process of manufacturing, or presented in a very large 
proportion of gelatin, albumen or peptones. Gelatin, 
albumen, etc., have been employed in the manufac- 
ture of " pure scale pepsin ; " the main object being to 
trade upon the reputation of the original Fairchild 
pepsin in scales the value and reputation of which 
have made the title scale pepsin of such commercial 
importance. The peptone is the product of the self- 
digestion of the lining membrane in acidulated water with 
heat; the ferment thus dissolves the proteid matter in 
which it is secreted, or which may be added, just as diastase 
dissolves the starch in the germinated barley or malt. 
There is thus a distinct analogy between maltose (malt 
extract) containing free diastase, and peptone containing 
free pepsin. The peptone is objectionable to just that 
degree that it dilutes the pepsin, renders it hygroscopic and 



50 

prone to spoil. The chemical treatment, the condensation 
by heat of the peptone solution to a scaling consistence may 
account for the great variation in activity of some of these 
products possessing practically identical physical prop- 
erties. At present we can only test pepsin by its action on 
albuminous matter in acidulated water. The form of albu- 
men most uniform, convenient and satisfactory is the 
white of egg. It is but a few minutes' work to form 
some opinion of any brand or specimen of pepsin by ascer- 
taining if it has any marked action on gelatinous egg 
albumen in warm acidulated water. Gelatinous albumen, 
made by dissolving fresh white of egg in cold water and 
boiling well and adding the HC1. digests much more rapidly 
than coagulated albumen. It forms a thick, opaque muci- 
lage, very similar to gelatinous starch and behaves with 
pepsin just as gelatinous starch does' with diastase ; the 
active ferment converting it instantly into a thin, watery 
solution. Thus the physician or pharmacist can at least 
readily discover an inert or worthless product. To determine 
the actual digestive power of any product, it is necessary to 
test it upon albumen under definite conditions well known 
to be favorable to the action of the ferment, employing a 
sufficient quantity of albumen to leave such an excess as to 
make sure that the ferment has exhausted its activity. There 
is a very important relation between the proportion of acid, 
water and albumen. This should be so adjusted as to give a 
definite, proper percentage of free acid in the mixture. The 
albumen alkali neutralises a certain amount of the acid ; the 
acid forms certain combinations with the albumen at 
various stages of digestion. A test mixture may appear to 
have less acid than another, yet have more acid, owing to 
the small proportion of albumen to acidulated water and 
vice versa. The parts of acid to parts of water must then 
be regulated according to the proportion of albumen to 
acidulated water. The U. S. P. test, for instance, has less 



51 

than the usual albumen and a greater proportion of acid to 
a given volume of water, and has thus too much free acid 
and is not a well adjusted test. In tests so adjusted as to 
start with exactly parallel quantities of ferment and albu- 
men and acid, the results will vary with the volume 
of water. The larger the proportion of water within 
limits, the more digestion ; with too little water the 
fluid soon becomes clogged with the products of diges- 
tion. The acid hydrochloric U. S. P. of commerce 
varies in percentage of absolute acid. Therefore it is well 
to employ acid of a known strength and to use the same 
specimen of acid in a series of experiments. The quantity 
of albumen necessary for a series of tests should all be 
prepared at one time. The water, acid and albumen 
always mixed before adding the pepsin. Pepsin acts upon 
albumen at from 6o° F. to 140° F., and the rapidity of 
digestion keeps pace with the temperature up to 130 F. 
At blood heat the results give more significance as to the 
effect of the ferment in the body. Five or six hours, the 
usual time, also provides ample opportunity for a full 
practical test. But the pepsin which gives best results at 
105 , will give the best results at 130 and it would be 
practicable to make a test which at 130 might be equiva- 
lent to the usual test, be much quicker and equally 
reliable. 

It is sometimes proposed to test pepsin by the amount 
of peptone formed. This, whilst theoretically exact, is im- 
practicable and unnecessary. There are a variety of soluble 
derivatives of albumen not well understood and difficult and 
tedious of assay even with experience. Solution is the char- 
acteristic effect — the pepsin which converts the most albu- 
men into solution is the most active and will have formed 
necessarily the most of all soluble products, peptones, etc. 
No two published tests at the present time call for exactly 
the same proportions ; the same product will give varying 



52 

results in each test. It is very important, therefore, that 
we should have a standard test and that the digestive 
power stated for each and every pepsin, or preparation of 
pepsin, should be that determined under the standard 
conditions. Whatever the quantity of albumen used 
(according to the strength of the pepsin) the ratio, the 
proportion of albumen, water and acid should always be 
the same. We have employed these proportions : Coagu- 
lated Egg Albumen, 150 grains (10 Cm.), Water, 1 fluid 
ounce (29.7 c.c.), Hydrochloric Acid, 5 minims (0.3 c.c.) 

In the comparative tests it is essential that the condi- 
tions shall be exactly alike in each test. The mixtures 
should all be prepared cold in bottles of the same size and 
well shaken to secure uniform conditions before add- 
ing the pepsin. Then the ferment added and all the 
flasks placed at once in a warm chamber with constant 
temperature of 105 ° F. on an automatic shaker. The 
pepsin should be weighed and added direct to each flask. 
It is impossible to reach accurate results in comparative 
tests by triturating the pepsins with water and taking 
definite amounts of the solutions or mixtures. The prod- 
ucts vary so much in solubility that the more freely 
soluble, by this method, are at an advantage. The pro- 
portion of albumen dissolved, the percentage left at close 
of test affords fair evidence of the digestive value of 
each specimen. 

EXTRACTUM PANCREATIS. 
(fairchild.) 

This extract of the pancreas presents all the active 
principles of the gland in the form of a dry, whitish 
powder. It is not an artificial compound, it is absolutely 
free from all added substances, and contains the ferments 
as they are naturally associated. 



53 

The Extractum Pancreatis which we originated in 1881 
was the first product offered to the medical profession 
containing all the pancreas principles in a pure, dry 
powder. It was originally far more active and available 
than any other pancreatic product (the pancreatines were 
practically useless), and since then, the Extractum Pan- 
creatis has shown the result of the persistent efforts to 
increase its efficiency and refinement. It is not too much 
to say that probably no remedial agent introduced during 
this decade has been of greater importance and value in 
practical medicine. Whilst the complex digestive action 
of the pancreatic juice was well known to physiologists, 
it had been but little utilised previous to the introduction 
of Fairchild's Extractum Pancreatis. 

By means of the Extractum Pancreatis, the pancreas 
ferments are now effectively administered and are steadily 
advancing in repute as therapeutic agents. The Extractum 
Pancreatis has further been the means and tne basis of ail 
the great progress made in the peptonising process, which 
has revolutionised the feeding of the sick and provided the 
long sought means for the conversion of caseine to the 
requirements of the infant's stomach and to the standard 
of mothers' milk. 

As a solvent for diphtheritic membrane and as a "sur- 
gical solvent," the Extractum Pancreatis has been so 
successfully applied, as to merit far more extended use 
and promise a still wider increase of utility. The Extractum 
Pancreatis is by far the best simple product from the 
gland and inasmuch as " pancreatines " are often unfit 
for medicinal uses and are for the most part valueless, 
it is well worth while to avoid disappointment by speci- 
fying Extractum Pancreatis, Fairchild. 

The Extractum Pancreatis presents all the digestive 



54 

ferments of the pancreas in an exceedingly active form 
— viz.: 

TRYPSIN, which converts albumens (of Milk, Betf, Fish, 
Blood, etc.) into Peptone in either neutral, alkaline, or 
slightly acid media. 

DIASTASE, which converts starches i?ito dextrines and 
sugar. 

THE EMULSIVE FERMENT, essential to the assimila- 
tion of fats and oils. 

THE MILK-CURDLING FERMENT. 

This EXTRACT OF THE PANCREAS contains all 
these digestive principles in such a degree of activity that their 
presence and their action upon various food substances can be 
quickly demonstrated. 

EXTRACTUM PANCREATIS. 

AS A REMEDY PER SE. 

* ' The pancreatic secretion is the most energetic and general in its 
action of all the digestive juices. It unites in itself the action of the 
saliva and the gastric juices, besides having properties of its own." — 
T. Lauder Brunton. 

In view of the very partial transformation of carbo- 
hydrates and proteids by the salivary and gastric juices, 
preliminary to further and complete digestion by the . 
pancreas juice, it would seem that an active extract of 
pancreas should possess remedial value of corresponding 
importance. The use of the pancreas ferments as aids to 
digestion has, however, been much prejudiced by theoreti- 
cal views, and especially by the erroneous impression that 
they are only active in alkaline media. The questions as 
to whether the pancreatic ferments are capable of exerting 
any influence upon food in the presence of the gastric 
juice, the effects of the gastric juice upon them, have 



55 

been the subject of much experiment and discussion, result- 
ing in conflicting theories and conclusions ; some asserting 
that the pancreas ferments can resist the gastric juice, 
others that they are therein rendered permanently inert. 
That in the flask the pancreatic ferments are destroyed by 
free hydrochloric acid plus pepsin, is, we think, beyond 
question. In discussing the compatibility and value of 
solutions of the mixed ferments (gastric and pancreatic) we 
pointed out the fact that in a solution with pepsin and acid, 
the pancreatic ferments gradually become inert, the practical 
lesson being plainly that the chemist should not offer, nor the 
physicians accept, remedies of this class. But to determine 
the bearing of these facts upon the exhibition of the pan- 
creatic ferments it is necessary to consider (as in the case 
of all such experiments) the relations which the test tube 
conditions bear not only to those of normal digestion, 
but to the abnormal conditions which call for the ad- 
ministration of the ferments. Our present knowledge 
of the phenomena of normal gastric digestion plainly 
shows that there are opportune intervals for the presumably 
effective introduction of the pancreatic ferments. This is 
admitted even in the most conservative estimates of their 
utility. There is the resource of specially adapted 
pharmaceutical products. There is a marked difference 
in the nature and degree of the acidity of gastric juice 
during stomach digestion. There are always organic 
acids set free from the food, and thus replacing a por- 
tion of the hydrochloric acid ; the hydrochloric acid is 
not free and uncombined, and the gastric juice does 
not correspond in its behavior to a simple solution of 
similar percentage of free hydrochloric acid in water. 
The presence of the products of digestion both pro- 
teids and carbo-hydrates may greatly influence the be- 
havior of these ferments when brought into contact. In 
a word, in the phenomena of digestion we have factors 



56 

which materially differ from those of laboratory experiments 
and must necessarily, therefore, qualify the deductions 
therefrom. Among those physicians who have given 
practical trial to the Extractum Pancreatis in intestinal 
indigestion, carefully regulating the mode of adminis- 
tration, there exists no question of its distinct therapeutic 
value. The feebler the digestion the less the question 
of interference of the gastric juice is to be considered. 
The Extractum Pancreatis is to be regarded first, as a dias- 
tasic agent ; second, as a digestive of albuminous food ; 
third, as the only means of administering the ferment 
which digests fat. Foster's Physiology says, " there is no 
means of distinguishing the amylolytic ferment of the 
pancreas from ptyalin." Therefore, the Extractum Pan- 
creatis may be given as aid to digestion of starches — 
either at the outset of, or at proper intervals after 
gastric digestion. Given at the interval after eating, 
when the gastric action has subsided, and the ingesta 
freely passing into the duodenum, the pancreatic extract 
(in the form of tablets preferably) may be effectively 
administered in intestinal indigestion. In cases of almost 
complete abeyance of the digestive functions, as in 
fevers, etc., the stomach affords the necessary condi- 
tions for the action of the pancreas ferment which may be 
given mixed with a suitable food, such as milk, cold or 
warm. In such cases, it will be found on trial that no 
preliminary digestion (peptonisation) is necessary to 
insure the proper conversion of the food without taxing 
or disturbing the stomach itself. This is not stated on 
the basis of theory, but as supported by actual clinical 
experience. 

The Extractum Pancreatis may be given in three to 
five grain doses— in powder mixed with food, in capsules, 
or Fairchild tablets, or in suitable combination. The 
Extractum Pancreatis has beerii upon theoretical and practU 



57 

cal grounds, recommended in the treatment of diabetes. 
As a rational remedy for insufficient salivary digestion, for 
intestinal indigestion, it is constantly gaining the confi- 
dence of the profession. 

TRYPSIN. 

(fairchild.) 

especially prepared as a solvent for 

diphtheritic membrane. 

This product presents the proteolytic ferment of the 
pancreas in the most active form obtainable. 

Trypsin has the property of digesting fibrin with 
great rapidity. 

It is most effective in a slightly alkaline solution, but 
may be effectively applied direct to fibrinous membrane, 
etc., either dry or in pure water. 

It is an entirely innocent and non-irritant substance, 
and does not attack the healthy or non-fibrinous tissue. 

In its application to the throat all the conditions are 
favorable to its physiological action. 

Trypsin will be found to be a powerful solvent of 
diphtheritic membrane in all cases in which it is prac- 
ticable to bring it in contact with the membrane. 

Trypsin is especially useful in cases where acid media 
is not admissible, and is to be chosen also in all situations 
where the smallest possible bulk of solvent agent is 
desirable. 

Trypsin may be applied by insufflation, pure or mixed 
with sodium bicarbonate — four grains Trypsin to one of 
soda ; or may be taken up on a wetted brush or probang, 
or mixed with water and sprayed ; Trypsin, gr. 15, soda 
bicarb., gr. 5, water, f ? i, to be prepared fresh every 
few hours, or chloroform or pure creosote, 4 drops, may 
be added as a preservative. For further details, see sur- 
gical use of the digestive ferments, p. 83, et seq. 



58 

DIASTASIC ESSENCE OF PANCREAS. 

(fairchild.) 

the most active, reliable and agreeable agent for 

the digestion of farinaceous foods. 

This preparation has been made with the especial pur- 
pose of obtaining the diastase or starch-digesting principle 
in an active and agreeable form. 

The need had been often expressed to us by physicians, 
of a purely diastasic preparation by means of which they 
might assist the digestion of starch without at the same 
time introducing other digestive agents, or in any other 
way interfering with the process of digestion. 

In meeting these requirements, this Essence has, we 
believe, been found peculiarly serviceable. It acts upon 
starch with great energy and promptness. 

Inasmuch as the diastase of the pancreatic juice acts 
upon starch in a manner precisely similar to that of the 
saliva, this Diastasic Essence may be confidently expected 
to compensate for insufficient salivary digestion. 

For this purpose it should be given at meal time — 
either immediately before or with the food. 

When the intestinal digestion of starch is at fault, it 
should be given an hour or so after food. 

This Essence of Pancreas is gratefully aromatic and 
acceptable to the most delicate stomach, and will be found, 
therefore, more efficient and agreeable as a diastasic agent 
than the thick, sweet extracts of malt. 

It will sometimes be advantageous to mix the diastasic 
essence directly with the foods, such as oatmeal, rice, 
etc., especially for children who, owing to defective denti- 
tion or ill health, evince difficulty in the digestion and 
assimilation of starchy foods at an age when it is desira- 
ble that milk should no longer be the sole article of diet. 

The Essence should never be added to food when too 
hot to be borne agreeably by the mouth. 

Usual dose^ one or two teaspoon 'fids. 



59 

PEPTONISING TUBES 

(fairchild.) 

for the preparation of peptonised milk and other 

predigested food for the sick. 



(Exact Size.) 

Each tube contains the exact quantity of Extractum 
Pancreatis (grains 5) and of Soda Bicarb, (grains 15), to 
peptonise one pint of milk. 

These tubes of "peptonising powder " are the most 
convenient means for prescribing and using the Extractum 
Pancreatis for the purpose of peptonising milk. 

By this means the peptonising powder is supplied in an 
accurate and portable form, secured from deterioration, 
and dispensed at a moderate fixed price. 

Each package contains complete directions for prepar- 
ing peptonised milk, beef, gruel and a great variety of 
foods for the sick by means of the Fairchild Practical 
Recipes. 

The tubes can be sent by mail. Retail price, 50 cents 
per box of one dozen tubes. 

FAIRCHILD'S " DIRECTION SLIPS " 

FOR THE USE OF THE PHYSICIAN IN PRESCRIBING 
PEPTONISED MILK, BEEF, GRUELS, ETC. 

For the convenience of the physician we devised these 
"direction slips" in small pads of proper size for the vest 
pocket. The pad contains a number of slips of direc- 
tions for each sort of food— peptonised milk by the cold 
process, and for jellies, for punches, etc.; peptonised 
gruel, peptonised beef, junket, whey, etc. 

By this means the physician is enabled to leave with 
the patient or nurse plain printed directions for the 
special food and method he may desire to order. These 
direction slips have proven very acceptable to the profes- 
sion. We shall be pleased to send them by mail upon 
request 



60 
PEPTOGENIC MILK POWDER 

YIELDS A FOOD FOR INFANTS WHICH IN PHYSIOLOGICAL, 

CHEMICAL AND PHYSICAL PROPERTIES IS ALMOST 

IDENTICAL WITH HUMAN MILK, AND AFFORDS 

A COMPLETE SUBSTITUTE THEREFOR 

DURING THE ENTIRE NURSING 

PERIOD. 

By means of the Peptogenic Milk Powder and process, 
cows' milk is so modified and pre-digested as to con- 
form remarkably in every particular to normal human 
milk, thus affording a " humanised milk," exactly suited 
to the functions of infant digestion, calling forth the 
natural digestive powers of the stomach and supplying 
every element of nutrition competent for the nourish- 
ment and development of the healthy nursing infant. 

It is also a peculiar feature of this method that the 
milk may be given just that degree of digestibility suitable 
to especial requirements, — in cases of naturally feeble 
digestion and during the disorders of infancy. 

The Peptogenic Milk Powder is put up in $1.00 and in 
jo cent packages, and sold by the principal drug houses in the 
United States and Canada. Sample can of the Peptogenic 
Powder and pamphlet will be sent gratis upon request. 
Correspondence solicited. 

TESTS FOR PANCREATIC PREPARATIONS. 

The pancreatic juice and the gland itself are well 
known to be extremely subject to decomposition, hence 
the greatest care and skill are required in manufacturing 
available medicinal products from this source. The 
value of a pancreatic preparation must depend not only 
upon its digestive activity, but upon the character, the 
quality of the digested product it yields. A pancreatic 
extract may convert the caseine of milk into peptone, yet 



61 

the peptonised milk be quite unfit for food, owing to the 
development of rancid fatty acids, giving the milk a pecul- 
iar repulsive odor characteristic of regurgitated milk from 
a sour stomach. A pancreatic preparation which produces 
such a result with milk, is plainly unfit for any medicinal use. 

We have in the past not infrequently had occasion to 
examine such commercial " pancreatines." A good pan- 
creatic extract should rapidly digest milk, beef, fibrin and 
all forms of starchy food, — should convert the caseine of 
warm milk into peptone without the development of any 
rancid flavor whatever. The action upon caseine may be 
taken as a sufficient test of the proteolytic power upon 
any proteid. The activity and quality of a pancreatic 
preparation may be readily tested in the following manner : 

Put into a flask 15 grains of sodium bicarbonate and 
4 fluid ounces of cold water, add 5 grains of Extractum 
Pancreatis, mix well and add one pint of milk warmed 
to 130 F. Shake well and place the bottle convenient 
for observation. At first there should be no foreign 
odor or taste imparted to the milk. In a few moments 
the milk will become of slightly grayish yellow color, 
which in ten minutes will be more marked and the milk 
thinner and of a distinct bitter taste, due to the conver- 
sion of the caseine. This taste, even when peptonisation 
is complete, is a pure bitter without any suggestion of 
fermentation or rancidity. By having another flask of 
the milk mixed with the soda and water without ferment, 
the progress of the digestion may be, by comparison, more 
readily observed. These physical changes of milk, during 
peptonisation, are so characteristic, that anyone familiar 
with the process, may very readily regulate the process 
accordingly. By withdrawing a small portion of the 
milk from time to time and adding a few drops of 
acetic acid, the conversion of the caseine may be tested, 



62 

by the character of the curd formed — from the familiar 
tough caseine, to the light, flocculent precipitate, and the 
final slight, scarcely perceptible, granular coaguli. 

To test the diastasic property of a pancreatic prepar- 
ation, prepare thick, gelatinous starch, by mixing a drachm 
of arrowroot or starch with five fluid ounces of cold water, 
and boiling well. To a fluid ounce of this mucilage (at 
uo° F.), add a grain or so of the pancreatic extract or a 
few drops of a fluid product and stir well. The starch 
should become almost instantly thin and fluid, like water, 
showing the formation of soluble starch, which is grad- 
ually converted into dextrine and glucose. A product 
which does not quickly liquefy thick, warm starch jelly 
is worthless as a diastasic agent. 

FAIRCHILD'S DIGESTIVE TABLETS. 

A PORTABLE AND EXACT FORM OF DOSAGE OF THE 
DIGESTIVE FERMENTS. 

These tablets are unique in form, agreeable to the 
taste and easily carried about in the pocket. They are 
offered as a means of exhibiting the digestive ferments in 
divided doses and at the particular interval after the in- 
gestion of the food, which gives the most favorable con- 
dition for their action. The advantages of this method 
of administration are apparent, especially in duodenal 
dyspepsia. The tablets should preferably be swallowed 
whole. 

The various combinations are supplied in small vials 
and it is recommended that they be prescribed in original 
bottles. The directions of the physician will be affixed 
by the druggist in place of our label, if so desired ; but 
it will be economical to the patient to order the original 
vial. They are also supplied in large vials in any quan- 
tity desired. 



63 
PEPSIN TABLETS. 

(fairchild.) 

Each tablet contains one grain of our pure Pepsin in 
Scales, combined with acids and appropriate aromatics. 
Dose — one or two tablets immediately after eating and 
repeated when required. 

These tablets afford a means of re-enforcing the gas- 
tric digestion at frequent intervals after the ingestion of 
food. The advantages of this method of administering 
the peptic ferment have been well advanced in an editorial 
in the New Remedies, from which we quote; and the need 
of an available preparation for the purpose having been 
urged upon our attention, we originated these Pepsin 
Tablets which have proven very useful and greatly 
appreciated. 

11 Still another fact exists, although it has apparently been lost sight 
of in practice, and is rarely or never mentioned by writers on disorders 
of digestion, viz. : that much better results will follow the administra- 
tion of the pepsin in divided doses during the process of digestion, and 
at intervals of a few minutes, than when it is given in one dose. The 
reason for this is the fact that as peptones are formed in the stomach, 
they are absorbed or passed through the pylorus into the intestine, and 
carry with them a certain proportion of the ferment which produces this 
change, and that in a case where the gastric juice is of notably poor 
quality, and artificial pepsin is employed, the digestive action, which 
at first may be quite efficient, grows weaker and weaker, and fresh sup- 
plies of pepsin are required from time to time to maintain the pro- 
cess. * * * " — New Remedies. 

PEPSIN AND BISMUTH TABLETS. 

(fairchild.) 

Each tablet contains one grain of pure Pepsin (Fair- 
child) and two grains of Bismuth Subnitrate. 

Pepsin and Bismuth constitute one of the most efficient 
and generally used combinations in the treatment of 



64 

dyspepsia. In these tablets these remedies are presented 
in an exact, agreeable and efficient form. 

The well-known chemical incompatibilities between 
Pepsin and Bismuth, in solution, and the criticisms justly 
urged against such a combination, have led some to the 
impression that this objection is true of Pepsin and Bis- 
muth mixtures generally. 

There is no question of incompatibility between Pepsin 
and Bismuth, except as relates to the Ammonia Citrate in 
solutions, a salt of Bismuth, moreover, which is greatly 
inferior to the Subnitrate. The Bismuth Subnitrate is well 
known to be very beneficial in certain forms of dyspepsia, 
and its properties are in no way inimical to the action of 
the gastric juice or to that of artificial peptic agents 
administered in conjunction with it. 

Usual Dose. — One or two tablets immediately before or 
after each meal, or at any time when suffering from indigestion. 

PEPSIN, BISMUTH AND PANCREATIC TABLETS. 

(fairchild.) 

Each tablet contains — Pepsin (Fairchild), i-J- grains, 
Ext. Pancreatis (Fairchild), i-J- grains, Bismuth Subnitrate, 
2 grains. 

Usual Dose. — One or two of these tablets should be taken 
either shortly before or after meals, as may prove best suited to 
the particular case. 

"PEPSIN AND PANCREATINE" TABLETS. 

(fairchild.) 

Each tablet contains — Pepsin (Fairchild), 2 grains, 
Extractum Pancreatis (Fairchild), 3 grains. 



65 

This formula has been prescribed for some years by 
physicians of this city under the name of " Pepsin and 
Pancreatine," and we have supplied them uncoated for 
dispensing. The increasing demand made it necessary 
for us to prepare them in a manner uniform with our other 
digestive tablets, in order to permanently protect them 
from change. 

The coating is perfectly soluble, and does not interfere 
with their digestive action. 

One tablet, three times a day, is generally prescribed as a 
dose. 

PEPSIN AND DIASTASE 

(fairchild.) 

in tablets, each containing two grains. 

This combination, which is original with us, is the only 
preparation in which the pure diastasic and peptic ferments 
have, we believe, been united in an active form. The 
value and appropriateness of this combination is apparent. 

It is certainly in clearest accordance with physiological 
principles. It is a well-ascertained fact that diastase, 
whether obtained from saliva, the pancreatic juice, or from 
germinated grain, acts upon starch in an identical manner 
and under identical conditions. " Pepsin and diastase " 
may, therefore, be given with every anticipation of benefi- 
cial results in cases of dyspepsia, where both the salivary 
and gastric digestion are at fault. 

This combination is prepared with our pure pepsin, with- 
out admixture of malt sugar, starch or other substance, and 
in such a manner that an ordinary dose contains an 
efficient proportion of the diastasic ferment. 

This product is not to be classed among those sacchar- 
ated " digestive compounds " which purport to contain "all 



66 

the agents of digestion " — diastase included. It is sufficient 
here to say that not one of them contains an appreciable 
quantity of diastase from any source. If a preparation 
contains active diastase, it must liquefy gelatinous starch 
at the temperature of the body. 

One or more tablets for a dose at meal time, or when suffer- 
ing from indigestion. 

PEPSIN, BISMUTH AND NUX VOMICA 
TABLETS. 

(fairchild.) 

Each tablet contains Fairchild's Pepsin, 3 grains, Bis- 
muth Subnitrate, 2 grains, Extract Nux Vomica, \ grain. 

COMPOUND OX GALL TABLETS. 

(fairchild.) 

Each tablet contains — Inspissated Ox Gall (Fairchild), 
2 grains, Extractum Pancreatis (Fairchild), 2 grains, Ex- 
tract Nux Vomica, \ grain. 

These two combinations having been much prescribed, 
we have manufactured them in our tablet form by request. 

PANCREATIC TABLETS. 

(fairchild.) 

Each tablet contains 3 grains Fairchild's Extractum 
Pancreatis. 

COMPOUND PANCREATIC TABLETS. 

(fairchild.) 

This tablet, originally designed for the treatment of 
intestinal indigestion, has proven of great service and has 



67 

been for some years extensively prescribed. The pure 
Extractum Pancreatis is here combined with bismuth sub- 
nitrate, highly esteemed in allaying irritability of the ali- 
mentary tract, and with ipecac, which, in small doses, is 
the most admirable stimulant of the intestinal digestion. 

Each tablet contains — Extractum Pancreatis (Fair- 
child), 2 grains, Bismuth Subnitrate, 3 grains, Powdered 
Ipecac, y 1 ^ grain. 

One or two tablets for a dose, an hour or two after eating. 

PEPTONATE OF IRON 

(fairchild), 

in tablets, each containing three grains. 

Dose for an adult, usually one tablet thrice a day after 
meals. 

FERROGLOBIN TABLETS. 

Ferroglobin contains the element iron, united with 
the proteid matter, as a constituent of the molecule itself, 
thus presenting this important principle in a form peculiar 
to the blood and impossible to produce artificially. Ferro- 
globin, therefore, may be considered to offer many advan- 
tages over any chemical compound of iron or any of the 
mixtures of iron and albumen. Ferroglobin, in distinction 
from all such artificial compounds, presents the organic, 
physiological ferruginous element of the blood. It is 
recommended in all anaemic conditions where it is desired 
to administer iron in a perfectly soluble and assimilable 
form. It is prepared with the utmost care and offered in 
tablet form as the most permanent and acceptable prepa- 
ration for medical use. 

Each tablet contains 2 grains of pure Ferroglobin. 

THE PEPTONISING PROCESS. 

To peptonise food is to artificially digest food, to submit 
it to the action of the digestive ferments, by which means 



68 

changes are effected precisely similar to those which in the 
living body are the essential preliminary to its absorption. 
For the two great types of food stuff, flesh and starch foods 
are incapable of being absorbed until they have become 
soluble by the action of the digestive juices, and thus 
capable of passing through the walls of the alimentary 
canal. This characteristic action of the digestive ferments, 
the conversion of insoluble and unabsorbable substances 
into soluble and assimilable, is seen in the artificial 
digestion of food. 

The fibre of beef is seen to gradually soften and dis- 
solve ; thick, well-boiled, gelatinous starch (gruel) is 
seen to quickly dissolve, become thinner and watery. Fari- 
naceous foods as ordinarily prepared, such as oatmeal, 
wheaten grits, rice, dipped toast, more slowly soften and 
dissolve. Albuminous substances, such as the caseine of 
milk, etc., acquire when completely digested, a bitter taste 
from the peptone ; the farinaceous foods become sweeter 
from the maltose or starch sugar. 

Cooked food is in general more susceptible to digestion 
than raw food, both in the body and in the flask. To pep- 
tonise food is then but to go a step beyond what has 
always been sought, in the special care and devices given to 
the cooking of food for the sick. 

Each ferment has its special correlated food substance 
and this it will digest in a flask, just as in the alimentary 
canal. In discussing the ferments in detail, we have already 
had occasion to point out that pepsin is not available for 
household use in artificially digesting food of any kind. 
Peptonised food is, therefore, not food prepared with pep- 
sin, or indeed necessarily containing a ferment of any 
kind ; it is digested food ; the agent of digestion may 
or may not be retained in an active form after its work 
has been utilised. 



69 

The pancreatic ferments are capable of digesting every 
known form of food ; and as made available in the Fairchild 
Extractum Pancreatis, Peptonising Tubes and other special 
forms, may be applied with marvelous facility for pepton- 
ising food for the sick by the Fairchild process, with the 
ordinary conveniences of the sick room. 

The peptonising action is most energetic at about the 
heat of the body, slow at the temperature of a room (60 to 
70 degrees F.) ; at a lower temperature, even at freezing, 
the peptonising agent is not destroyed, but is simply in- 
active. At the boiling heat it is at once killed. 

Therefore we may peptonise milk by the cold process, 
in which the major work of the peptonising agent is done 
after the milk is taken into the stomach ; or by the warm 
process in which the milk is partially digested and then 
cooled to check digestion ; or after peptonising to a cer- 
tain point the ferment is to be destroyed by boiling. 

This boiled or scalded peptonised food contains now 
no active ferment, no artificial help to digestion ; we have 
removed the food from further influence of the peptonising 
agent, just as we remove food from the fire after cooking. 

It will be seen, therefore, in the Fairchild's practical 
recipes that we have various simple methods, according to 
the degree of peptonising required, to suit the conditions 
of a case. 

The effects of the peptonising process are as plain to 
sight and to taste, as are the effects of cooking and afford 
as simple evidence by which it may be regulated. It is in 
truth easier to tell when a pint of milk is peptonised to 
suit a given case, than it is to tell when an egg is boiled 
"soft," or "well done" or when a steak is properly 
broiled. 



70 

The peptonising powder always acts uniformly under 
given conditions ; those conditions are exceedingly simple 
and attainable. 

It is of the greatest importance at the beginning, to 
follow the directions to the letter. With familiarity with 
the process, with its effects, with a clear idea as to the 
conditions essential and the object to be accomplished, 
then one may take one's " own way " to reach the desired 
result, to please, or agree with, any patient. 

For instance, if peptonised milk should be required in 
an emergency, the powder may be mixed in a saucepan 
with warm water and warm milk and kept warm over a 
fire, say for five minutes, stirring briskly, and sipping fre- 
quently so as to take care that the milk is not overheated 
and the ferment thus destroyed. Thus in a few minutes 
peptonised milk may be so prepared as to be of the 
utmost service in affording urgently required absorbable 
nourishment. It may be given hot, or if required cold, ice 
it. Sometimes it will be found that the milk will agree 
(when made by the warm process), if it is put on ice the 
moment the milk becomes warm in the bottle, because the 
milk thus becomes sufficiently peptonised before it becomes 
chilled. 

There is an exaggerated notion of the "trouble " of the 
peptonising process, probably because of the novelty of 
this application of physiological principles. But it is in 
reality an exceedingly simple process. It would be difficult 
to instance any of the commonest cooking operations so 
simple as mixing a powder, water and milk together and 
keeping it in a warm place (water bath or other) for a 
few minutes. If soluble, easily digestible, absorbable food 
is, as by all conceded, the chief desideratum, how shall we 
so simply, surely and safely obtain it as by the peptonising 



71 

process ? It is certainly far easier to peptonise food than to 
prepare most of the jellies, beef teas and delicacies in old 
time vogue for the sick. The peptonised foods have saved 
more lives in the ten years in which the Fairchild process 
has been in use, than all the other kinds of special foods for 
the sick that are made. It is scientific, practical, successful. 
If it chances that at the first attempt or occasionally, the 
milk becomes " too bitter," surely this- is no more reason 
for condemning the process or rejecting it, than it would 
be to reject cooking because of the even greater difficulty 
of boiling an egg "twice alike" or of roasting meat " to 
a turn." 

THE USE OF SODA IN THE PEPTONISING 
PROCESS. 

As we have already explained, the use of an alkali is 
not essential to the action of the pancreatic ferments. 

In the digestion of milk by the peptonising ferment the 
caseine undergoes gradual conversion, and at a certain 
point acquires the peculiar property of coagulating at the 
boiling temperature. 

The caseine at this stage of its conversion is in the con- 
dition most generally suitable for digestion in the stomach ; 
it is no longer caseine and does not act like caseine and yet 
not completely peptone ; for peptone does not coagulate 
when boiled. It is in fact a peculiar partially transformed 
albuminoid which has been called meta-caseine, and it 
has been found that this may be prevented from coagu- 
lating from boiled milk by simply rendering it alkaline. 
Consequently by the use of a small quantity of soda 
bi-carbonate we are enabled to boil the milk, and thus 
check digestion at any requisite stage without coagu- 
lating the altered caseine. It is seldom necessary to 



72 

boil peptonised milk for adults except under circum- 
stances when ice is not available to check the pepton- 
ising action. This addition of soda is also wholesome, it 
neutralises the almost invariable acidity of cow's milk and 
keeps it sweet. 

In the Fairchild process for peptonising milk we direct 
that the peptonising powder shall first be mixed with 
water and then added to the milk ; the object being to so 
dilute the milk that it will not be curdled by the digestive 
agent. The action of the pancreas curdling ferment, 
which we have described on page 34, is a hindrance to the 
artificial digestive process ; for milk will peptonise more 
readily, be more convenient for use, if kept fluid by the 
simple expedient of diluting it with a small proportion of 
water. 

THE REASON FOR DILUTING MILK IN THE 
PEPTONISING PROCESS. 

The Extractum Pancreatis contains the ferment of 
the pancreas which curdles milk. This ferment does not 
act well with diluted milk. Consequently, by the simple 
expedient of adding a small proportion of water, we are 
enabled to use the requisite quantity of Extractum Pan- 
creatis to peptonise milk, without any interference from 
the curdling ferment. 

The addition of water in this proportion is not in the 
least objectionable. For the great majority of cases in 
which peptonised milk is resorted to as a diet, the addi- 
tional water is a distinct advantage, for here it is that a 
fluid food is of the utmost importance. It means that the 
patient takes with every pint of milk four ounces of water, 
and water is, in fevers, etc., the very thing required. It is not 
so much concentrated food, as assimilable comprehensive 



73 

nourishment that is essential. In the special process for 
peptonising milk for infants, we direct the definite dilu- 
tion necessary to yield a food containing the proportion 
of water found in human milk. 

USES OF PEPTONISED FOODS. 

It is no longer necessary to adduce " clinical experi- 
ence " in support of the value of peptonised foods. Since 
we first had the honor to call the attention of the medical 
profession to the " Use of the Extractum Pancreatis in 
the Preparation of Peptonised Foods for the Sick," these 
foods have quite fulfilled their great promise of useful- 
ness. 

In a word, when the physician finds nutrition to be a 
factor in the treatment of a case, this is where peptonised 
foods are his chief resource. In peptonised milk, beef, 
gruels, etc., by the Fairchild process, the physician finds 
the food for the sick at once the most useful, economical, 
and congenial to direct for his patient. For the foods 
peptonised are the foods with whose composition and 
special nutritive properties and value, he and all mankind 
are familiar. 

If the digestive functions are impaired, or even com- 
pletely in abeyance, what other method of supplementing 
them so certain and so innocent ? It is the most rational 
conceivable resource to thus accomplish digestion by 
proxy — to the degree only necessary to render the food 
assimilable. With returning health, the patient neither 
desires nor requires peptonised foods. The use of pep- 
tonised food reduces to a minimum the inroads which 
acute and wasting diseases make upon the system. The 
physician rationally anticipates a better convalescence, a 
quicker renewal of normal digestive power, for that 



74 

patient whose nutrition has suffered the least degree of 
impairment. Let anyone compare the average results of 
the treatment, for instance, of " Typhoid" with the use 
of peptonised milk, with the results under the use of any 
other food. 

There is the record of ten years, of innumerable cases 
in the use of veritable peptonised foods by the Fairchild 
process, without the citation of a single case of unfavorable 
sequelae attributable to the use of these foods. 

In experiments also with animals fed upon peptonised 
foods, there is no evidence of inability to return readily 
to the digestion of ordinary food. There was on one 
side a mere unsupported conjecture as to what might 
be the effect of protracted feeding of peptonised foods ; 
on the other, we know its beneficial effect after ten 
years of experience as a therapeutic resource ; we know 
that we do with unqualified benefit to the sick, sub- 
ject food to preliminary digestion, and thus set disease 
at defiance in so far as it affects the most vital functions 
of digestion and nutrition. 

That peptonised milk is competent for the complete 
nourishment of adults in active life suffering from gastric 
ulcer, or subject to chronic diarrhoea, is abundantly proven, 
and many instances have occurred in the past ten years 
where patients have found this their only resource for 
nutrition.. We especially call attention to these typical 
cases, the personal experience of practicing physicians who 
have been enabled to pursue their profession and main- 
tain vigorous life by subsisting solely on peptonised milk 
for years, under circumstances where otherwise H life had 
been a burden " from suffering. 

" The history of this case of Acute Dysentery which 
" had progressed from acute suffering to exhaustion, emacia- 



75 

" tion and hopelessness ; which was not permanently bene- 
"fited, but only controlled by the numerous drugs used 
" against it, and which was at last cured by a simple diet 
" of pre-digested milk rigidly adhered to by the help of 
"obstinate will power, has appeared to me unique and 
" therefore of use to the profession at large. It demon- 
strates that by recourse to the artificial process of diges- 
tion, we may present proper nutriment to our patients 
"under conditions so unfavorable even as to render futile 
" all other therapeutic measures, climatic and medicinal. 
" It proves further, as will be shown, that under a pro- 
" longed exclusive diet of so fluid an aliment as milk diluted 
" with water and with its caseine converted into soluble 
"peptones, health and activity may be maintained." 

" Upon this diet, of milk peptonised by Fairchild's 
" method, the patient has now been living exclusively for 
" more than two years. His general condition is excellent. 
" The functions of the bowels are performed with ease 
" and regularity, his muscular system has regained its 
" former degree of average development, and he bears, 
"with the same ease, as do his fellows, the fatigues of 
" either business or pleasure." 

" As a physician of seventeen years of active practice, 
"I have fully convinced myself of the great value of your 
" * Pure Digestive Ferments ' — particularly your ' Ex- 
"tractum Pancreatis.' But my most valuable experience 
" has resulted from my own personal experience. For 
" three years I have suffered with gastric ulcer and 
" Chronic Gastritis with frequent acute attacks. Life was 
"intolerable and seemed about to terminate when I began 
"washing out my stomach with medicated water and 
"resorted to a diet of ' peptonised milk.' For 37 months 
" I have lived absolutely upon peptonised milk, porridge 
" and gruel." 



76 

In acute and wasting diseases, Typhoid, Pneumonia, 
Gastric Ulcer, Diabetes, Tuberculosis, Chronic Diarrhoea, 
Pyloric and Intestinal Obstruction, Gastric Catarrh, etc., 
as a food both preparatory and subsequent to important 
surgical operations, peptonised milk, gruel, etc., are the 
classical resource. In times of great fatigue and nervous 
prostration, when the strength is exhausted by severe 
strain of work and anxiety, when, as it is expressed, one 
is " too tired to eat," then peptonised milk has the most 
remarkable restorative power. See " Hot Peptonised 
Milk." {Practical Recipes^ 

In Typhoid Fever, peptonised milk promises, and 
proves the " ideal food ; " it precludes all accumulation 
of unassimilable matter in the digestive tract and meets 
every requirement. It affords also the best vehicle and 
the most agreeable for the exhibition of the spirits, whisky, 
brandy, etc. 

We do not recommend peptonised milk for feeding 
nursing infants, nor the use of the Peptonising Tubes, for 
preparing peptonised milk for infants. In " peptonised 
milk" (with the tubes), there is no attempt to adjust the 
milk quantitatively to a correspondence with human milk, 
nor to attain the definite proper conversion of the caseine. 
There is no reason, therefore, for using for an infant this 
method of peptonising milk designed for adults, when in 
the Peptogenic Milk Powder the process is, in every detail, 
adjusted to the analysis of normal human milk. 

Humanised Milk as prepared with the Peptogenic 
Milk Powder is frequently preferred by the physician as 
a food for adults — in phthisis, Bright's disease, etc., be- 
cause it is so fluid and agreeable, and yet richer in nutritive 
matter than pure cow's milk or peptonised milk, 



77 
PEPTONISED MILK. 

Peptonised milk, some ten years ago practically un- 
known, is to-day by far the most important and the most used 
by the medical profession of all foods for the sick. The 
reason for this is shown in the great value of milk as a 
comprehensive nutrient, in its availability and cheapness. 
In truth, a pint of peptonised milk contains more actual 
peptone, more total nutritive substances, than the same 
bulk of many so-called concentrated beef elixirs, wines, 
etc., which cost a dollar per pint. Milk contains every 
element of nutrition in a form naturally fitted for absorp- 
tion, with the exception of its caseine. Therefore, it is 
apparent that by changing the caseine into soluble pep- 
tone, we obtain an ideal food for the sick. 

Caseine is, of all albuminoids, the most difficult and 
impracticable of artificial digestion by pepsin and acid, 
either as existing naturally in milk or as separated there- 
from by acid or rennet, and treated just as we should 
treat egg albumen, fibrin, etc. Caseine is, moreover, 
unquestionably more difficult of digestion, even in the 
stomach, than other albuminoids, such as of fish, beef, 
egg, etc. 

It is not a little remarkable that milk, " the type of a 
complete aliment," should prove so marvelously susceptible 
to artificial digestion by means of the proteolytic ferment 
of the pancreas, for thus the caseine of milk can be at 
will brought to any desired degree of conversion without 
rendering the milk repulsive in taste or appearance. In 
fact, peptonised milk, when prepared according to the 
directions with the peptonising tubes, is quite as agree- 
able as raw milk, and better relished by most persons. 
By the " cold process " no artificial taste whatever is im- 
parted to the milk. Peptonised milk is milk with its 



78 

caseine converted into peptone by the process of arti- 
ficial digestion. The object of the directions given for 
peptonising milk is to submit its caseine to the action 
of the digestive ferment under the definite simple condi- 
tions by which it may be digested to any suitable degree 
of conversion. 

When well peptonised, the milk will be found to have 
become thinner and of a greyish yellow color, and to have 
a slight, peculiar and by no means disagreeable taste 
characteristic of peptonisation. Wholesome peptonised 
milk should not have the slightest rancid flavor or odor. 

It is very seldom necessary to peptonise the milk to 
the point at which the bitter taste is developed. It must 
be borne in mind that the peptonising process goes on as 
long as the milk is warm ; therefore it is necessary to 
transfer the bottle promptly from the warm bath to the 
ice chest, in order to check digestion. For various methods 
of preparing peptonised milk, for making it an agreeable 
beverage, see Fairchild's " Practical Recipes." 



NUTRITIVE ENEMETA. 

Peptonised Foods are peculiarly adapted for rectal 
alimentation. In the rectum is presented every condition 
essential to the conversion and complete absorption of the 
peptonised food, etc., without irritation or complication. 
In times past it has been recommended to prepare beef, 
etc., for enemas by mixing it into a pulp with the fresh 
pancreas gland. To-day, in the Extractum Pancreatis or 
the Peptonising Tubes, we have the means of quickly and 
conveniently preparing milk, beef, eggs, etc., as absorbable 
enemas capable of sustaining life for an indefinite time. 



79 



MILK ENEMETA. 



Milk may be introduced as soon as it is mixed in the 
ordinary proportion with the peptonising powder, and as 
it is usually required warm, a very considerable degree of 
pre-digestion will take place whilst bringing the milk to 
proper temperature ; or best, the powder should be mixed 
with ready warmed milk. 

Peptonised milk may be very conveniently prepared 
by the cold process, and when required the proper 
quantity may be warmed and injected. 

EGG ENEMETA. 

Dissolve the white of an egg in thrice its bulk of warm 
water ; add r the contents of a peptonising tube and stir 
well, and inject at once. An egg, white and yelk, may be 
thoroughly mixed with a pint of milk and peptonised 
in the usual manner, and thus afford a very nutritious 
enema. 

BEEF ENEMETA. 

Take a tablespoonful of minced lean beef, add to four 
tablespoonfuls of cold water, and gradually heat to boil- 
ing. Now rub all through a fine sieve or colander, and 
when luke-warm add the contents of a peptonising tube, 
and it is ready for injection. It may be made more fluid 
if desirable. 

PANOPEPTON. 

BREAD AND BEEF PEPTONE. 

Having been the first to realise the value and scope of 
the digestive ferments as artificial agents of digestion, 
and the originators of the Fairchild process, which has 
become familiar in every household for the peptonisation 
of food for the sick, we have not failed to perceive the 



80 

great need for a true, ready-made peptonised food. Pep- 
tonised foods by the Fairchild process have long been 
recognised as superior to all others available, the only 
objection being the necessity of preparing them fresh 
every day when required. 

In Panopepton we present to the profession a new, 
complete and perfect peptone, one which we are con- 
fident will meet every requirement. Panopepton is 
the entire edible substance of prime, lean beef and best 
wheat flour, thoroughly cooked, properly digested, steri- 
lised and concentrated in vacuo. The trimmed and 
cooked beef is subjected to digestion strictly to the point 
of complete solution of its albuminoids and the cooked 
wheat to the solution of both its gluten and starch. Pano- 
pepton is, therefore, the quintessence of peptones, contain- 
ing all the nutrients of these two great types of food, beef 
and bread, fused into a delicious restorative. 

The superiority of peptones from cooked foods over 
any form of raw, unsterilised beef is obvious. Sterilisa- 
tion is an essential feature of the process for Panopepton, 
peptones not being coagulable at the boiling temperature, 
as are all other forms of albuminoids. Expressed juice 
of beef is instantly coagulated by heat, showing the fact 
that its albuminoids require conversion into complete 
solution before they are fit for absorption. 

Panopepton is completely soluble and absorbable and 
responds to every test of true peptone and will satisfy the 
most exact and scientific scrutiny as to its qualities in 
every particular. 

As significant of the technical skill and care with 
which the Panopepton is prepared, we call attention to 
the important fact that it is free from cane sugar or con- 
diments, its agreeable flavor being purely characteristic 
and like that of roast beef juice and crust of bread. 



81 

Digestion is a process of solution, the slight mechanical 
operation concerned, being merely to expose increased 
surface to the solvent action of the digestive juices. By 
digestion only are we enabled to convert into solution the 
bulk, the actual substance, of food stuffs and thus fit them 
for appropriation by the system. We cannot by maceration 
or infusion with water, dissolve or extract the real nutri- 
tious substance of beef. The starch (the carbohydrate) 
of flour or bread, likewise, can be made soluble only by 
digestion. 

Panopepton contains not only such extractives, salts 
and savory matters, as are found in beef juices, beef tea, 
etc., but further and peculiarly, a solution of the whole 
substance of beef and bread. 

For many years the peptonisation of beef and wheat 
has been the subject of experiment and study by us, for 
we considered that in these combined albuminoids 
and carbohydrates only could we seek for a true and 
complete food. 

If, for the nutrition of the body in health, every form 
of alimentary substance is essential, why should we in 
disease resort solely to albuminoids or digested albumi- 
noids, except in the cases where especially indicated. The 
dietary experience of the human race is expressed in the 
saying, "bread is the staff of life." 

The rank which peptonised milk holds as a food for 
the sick is due especially to the fact that milk is the "type 
of complete aliments. ,, — (Dujardin-Beaumetz) ; "com- 
plete in itself." — (Pavy). Panopepton is the first food for 
the sick which may be relied upon to replace milk, for 
like milk, it affords all the elements requisite for the nutri- 
tion of the body. 

The uses of such a peptonised food product as Pano- 



82 

pepton are so obvious that it is only necessary to suggest 
the directions in which it will be found of inestimable 
value. Panopepton is the food par excellence, for invalids; 
in all acute diseases, fevers, etc.; in convalescence; for the 
large class of persons who from feebleness, or deranged 
digestion, or antipathy to ordinary foods, require a fluid, 
agreeable and quickly assimilable food. As a restorative 
from fatigue, for sleeplessness due to care and anxiety, 
or stress of mental work, Panopepton is a most potent re- 
constructive, to which immediate response is felt. Pano- 
pepton is preserved in a sound sherry, without added 
alcohol, and is at once a grateful stimulant and food. 

A wineglass of Panopepton, with a small biscuit or 
cracker, will be found the best lunch or supper for the 
brain worker, when too tired for the tolerance or digestion 
of ordinary foods. For invalids travelling and under any 
circumstances where it is inconvenient to prepare food 
for the sick, Panopepton may be relied upon. In seasick- 
ness it is especially acceptable. Panopepton will be found 
to be of the most agreeable flavor when taken cold, 
consequently we recommend keeping : it in a cool place, 
although it will keep perfectly for an indefinite time 
under ordinary conditions. 

Panopepton should not be mixed with milk or any 
other food, and whatever diet is ordered in conjunction 
therewith, the Panopepton is to be taken pure or diluted 
only with ice-water, carbonic water or wines. 

For Infants during summer complaint, Panopepton 
is a food rationally indicated and may be given in doses 
from a few drops to half-a-teaspoonful according to cir- 
cumstances. 

For adults the usual portion should be a small sherry 
glassful several times a day and at bedtime. 



83 

THE SURGICAL USE OF THE DIGESTIVE 
FERMENTS. 

It is a fact long known, that the action of the proteo- 
lytic ferment of the gastric juice is not confined to purely 
alimentary substances, but is capable of dissolving albu- 
minous matter in the various forms occurring in false 
fibrinous membrane, in sloughing and diseased tissues, etc. 

" Gastric Juice was many years ago employed by Dr. P. 
" S. Physick, the celebrated surgeon of Philadelphia, with 
" considerable success, as a local application to cancers and 
" sloughing ulcers, with the view of removing the dead bone 
" and flesh, correcting the offensive odor, and yielding a 
" healthy stimulus to the diseased surface. It has also been 
" used with success by Dr. Ellsworth, of Hartford. Conn., for 
" dissolving a portion of tough animal food, which had 
" become impacted in the oesophagus of a lad affected with 
"stricture of that passage. The gastric juice of a pig was 
"used. — {Boston Med. 6° Surg. Journ., April 17, 1856.) 

But the purely physiological functions of the digestive 
ferments and their application as agents of digestion 
of alimentary substances, have naturally more engaged 
the attention both of the medical profession and those 
who have sought to perfect the means and the method of 
utilising them in this most practical direction. Mean- 
while the surgical application of the digestive ferments 
has too long failed of that attention which the least san- 
guine estimate of their value must show them eminently 
worthy of. In recent years we have given considerable 
attention to this subject, and from time to time supplied 
the ferments in the best form available for this purpose. 
Medical literature shows the record of the successful use 
of Fairchild's pancreatic extract and pepsin in the throat, 
in the auditory canal, in ulcers, sloughing wounds, in the 
bladder, etc. A novel and most important application of 



84 

the digestive ferments in gonorrhea and urethral stricture 
has been made by a physician who has found Extractum 
Pancreatis the most successful agent. Applied dry it ad- 
heres to the mucous membrane, and finds sufficient 
moisture for its effective action. The Extract is pref- 
erably mixed with sodium bi-carbonate — say i grain to 5 
of the Extract. In this situation, as in all others observed, 
the ferment seems to exert no action upon normal tissue. 
A record of many cases has already been made, and the 
subject is still under investigation. A case has also been 
reported to us of the successful treatment of stricture of 
the oesophagus by application of the Extractum Pan- 
creatis with sodium bi-carbonate. In diphtheria, we have 
every reason to believe that the best results are to be ob- 
tained by the insufflation of the dry Extractum Pancreatis 
mixed with Sodium Bi-carbonate; thus applied, it adheres 
well to the mucous membrane, which affords sufficient 
secretion as a media for the solvent action. Dr. Robert T. 
Morris, a well known surgeon of this city, seeing the 
remarkable and signally successful use of Fairchild's pepsin, 
by his suggestion in the treatment of a crushed liver, was 
led to undertake scientific investigation and extended 
practical trial of the digestive ferments as solvents in surgi- 
cal cases. Subsequently Dr. Morris undertook a series of 
experiments, to test the solvent power of pepsin upon 
carious bone previously decalcified by subjection to dilute 
Hydrochloric acid, with the view to remove dead bone 
without subjecting a weak patient to a dangerous or 
deforming operation. Succeeding in these experiments, 
Dr. Morris made practical use of this new surgical resource 
with complete success, the pepsin liquefying the carious 
bone and exerting no action upon normal bone. 

The results of Dr. Morris' investigations are published 
in the New York Medical Journal, April nth, 1891 : "The 
action of pancreatic extract and pepsin upon sloughs, 



85 

coagula and muco-pus ;" and March 19, 1892 : "The re- 
moval of necrotic and carious bone with hydrochloric acid 
and pepsin. "* 

The grounds on which the digestive ferments are 
applied in surgery are admirably stated by Dr. Morris as 
follows : 

"It is not easy to see at a glance the whole field for digestive fer- 
ments in surgery, but we know that they are bland and harmless in any 
proportion, and that they will liquefy dead tissues close down to the liv- 
ing ones, and that there their action will end abruptly." 

From Dr. Morris' paper the following typical cases 
summarised : 

"A resource was brought into play a few weeks ago, when I had 
occasion to make suggestions relative to the treatment of a crushed 
liver. Portions of the organ, which were dark and sloughing, remained 
so firmly attached that their removal was dangerous, and the pultaceous 
lining membrane of the enormous abscess seemed to invite all manner of 
microbe guests. The idea of liquefying the dead tissues with a digestive 
ferment came into mind, and this being suggested, was carried into 
effect by the family physician, who injected into the abscess cavity a 
solution of scale pepsin, and, writing to me afterward, said : * The pep- 
sin did mighty good work. It broke up all dead tissues rendering them 
mostly liquid, and changed the color from brown to straw-color. The 
liquefied substances were easily washed out through the drainage tube. 
The wound was sterilised daily afterward with hydrogen peroxide, and 
the patient recovered without a bad symptom.' " 

" Dr. C. N. Haskell liquefied two grammes of tough lining membrane 
from the tuberculous abscess of a case of hip joint-disease, with pepsin 
in fifty-five minutes." 

" Dr. C. D. Jones, of Brooklyn, poured a solution of pancreatic extract 
(pancreatic extract, 2 dr.; water 8 ozs.) into the abscess cavity of a case 
of hip-joint disease one week after the operation of excision had been 
performed. He then wrote me as follows ; * The solution was allowed 
to remain in place half an hour, and the result was remarkable. Upon 
irrigation, I washed out numerous shreds of broken-down ligamentous 
tissue and many spicula of dead bone that had become imbedded in the 

*Reprints of these papers will be sent on application to us. 



soft tissues and that had previously escaped both irrigator and currette. 
The wound was then flushed out with hydrogen peroxide, and this treat- 
ment was followed by a marked improvement in the patient's general 
condition.'" 

M In one case in which the bladder contained blood-clots and the 
catarrhal mucous membrane discharged ropy muco-pus, pepsin injected 
for the purpose of liquefying the clots not only fulfilled its mission in 
that direction, but unexpectedly cleared out the muco-pus and left the 
interior of the bladder quite clean. The process was repeated as soon 
as the muco-pus again became abundant, and the patient experienced a 
feeling of relief after the simple cleansing that pepsin afforded." 

41 After much experimentation I have finally adopted a method of work 
which seems to be complete. An opening is made through soft parts by 
the most direct route to the seat of dead bone, and if sinuses are present 
they are all led into the one large sinus if possible. The large direct 
sinus is kept open with antiseptic gauze and the wound allowed to remain 
quiet until granulations have formed," 

44 Granulation tissue contains no lymphatics, and absorption of septic 
materials through it is so slow that we have a very good protection 
against cellulitis. The next step consists in injecting into the sinus a two 
or three per cent, solution of hydrochloric acid in distilled water. If the 
patient is confined to bed, the injections can be made at intervals of two 
hours during the day ; but if it is best to keep the patient up and about, 
the acid solution is thrown into the sinus only at bed-time. In either 
case the patient is to assume a position favorable for the retention of the 
fluid. Decalcification takes place rapidly in exposed layers of dead bone, 
and then comes the necessity for another and very important step in the 
process. At intervals of about two days an acidulated pepsin solution is 
thrown into the sinus (I use distilled water, f § iv ; hydrochloric acid, 
m, xvj ; Fairchild's pepsin, 3 ss.), and this will digest out decalcified 
bone and caseous or fatty debris in about two hours, leaving clean dead 
bone exposed for a repetition of the procedure. The treatment is con- 
tinued until the sinus closes from the bottom, showing that the dead bone 
is all out" 

11 Even in distinctly tuberculous cases the sinuses will close if appara- 
tus for immobilising diseased parts and tonic constitutional treatment are 
employed, as they should be in conjunction with our efforts at removing 
the dead bone." 

44 If suppuration is free in any cavity in which we are at work, it is 



87 

well to make a routine practice of washing out the cavity with peroxide 
of hydrogen before each injection." 

Pepsin is the ferment which will probably give the best 
results in all cases where the acid essential to its operation 
is not objectionable, and where the swelling of the fibrin- 
ous matter, which instantly occurs on contact with the 
acid is not an objection. This behavior of acid would 
sometimes be considered unfavorable, as in the auditory 
canal, in the throat and in the urethra ; but in abscess 
cavities, etc., this is no objection — on the contrary, the 
acid seems itself a salutary agent, giving a healthy stim- 
ulus to the diseased surface, and is, moreover, antiseptic. 
Further, the action of this acid-pepsin digestion ceases at 
the production of peptone. These pepsin peptones do 
not readily undergo themselves putrefactive changes 
whilst the solution remains acid. The pancreatic fer- 
ments acting upon all these forms of proteid encountered 
in surgical cases, are very effective in water without the 
intervention of an alkali, but their action is accelerated in 
an alkaline solution so slight as one part sodium bicar- 
bonate to 500 of water. Moist fibrin can as quickly be 
digested by Extractum Pancreatis plus alkali as with 
pepsin plus acid, by simply adjusting the quantity of the 
ferment to attain the desired result. There is no possible 
cause for hesitancy in using the ferment as freely as 
necessitated ; there is no other effect than its digestive 
action, which ceases when no morbid tissue remains to 
work upon. The soda itself is in many instances as 
clearly indicated and as useful, for instance in the 
urethra, in the bladder, in the throat, etc., as the acid is in 
the cases suitable for pepsin. 

In the surgical use of the digestive ferments, it is 
absolutely essential to follow as closely as possible the 
conditions most favorable to the action of the particular 
ferment utilised. At the outset, probably no better 



88 

guidance can be had than the procedure developed by 
practical experience in the use of the digestive ferments, 
as applied in this artificial digestion of albuminous matter 
in the test tube. 

In using pepsin, the intervention of acid, from one half 
to one per cent, hydrochloric acid, U. S. P. to the volume 
of water is essential. Extractum Pancreatis may be used 
with simple water, or with water rendered slightly alkaline 
with soda bi-carbonate, say 5 grains to each fluid ounce. 

The surgeon, then, in the normal range of media and 
action of the peptic and pancreatic ferments, is enabled to 
use an effective solvent, either acid, neutral or alkaline, as 
best adapted to the case in hand. 

The most favorable temperature for the preparation and 
for the action of the digestive fluids can be readily ascer- 
tained by any attendant without the use of the thermom- 
eter, by using water heated to the point at which it can be 
borne by the whole hand (115° F.), or not too hot to be 
swallowed with comfort, about 130° F. This gives a tem- 
perature of 115 or 130 F., at which they act better than 
at the body heat, and the water should always be brought 
to the proper temperature before adding the digestive fer- 
ment. This avoids all risk of injuring the ferment. 

If there is no cavity to hold the solvent in contact 
with the matter to be digested, the solvent should be 
applied by copious sprays, frequently repeated. In cav- 
ities, repeated applications are preferable, as otherwise the 
digestive fluid may become saturated with the products of 
digestion, and thus cease to act. It is also to be noted 
that the irrigation should follow as quickly as possible the 
liquefaction of the tissues. 

The solvents should invariably be freshly prepared for 
each application, as the ferments mixed with the water are 



89 

not only prone to decomposition and to become inert, but 
if mixed with cold water and then brought to the proper 
temperature each time required, they are very apt to 
be injured by overheating. With warm water, it is but a 
moment's work to prepare just the quantity required for 
each application. 

In using pepsin, we strongly recommend Glycerinum 
Pepticum, both for convenience and efficiency, as contain- 
ing the ferment in a highly concentrated, pure glycerin 
extract, instantly soluble in any desired proportion and 
especially convenient for spraying. 

GLYCERINUM PEPTICUM 
AS A SURGICAL SOLVENT. 

In any convenient glass, mix one teaspoonful of Glycer- 
inum Pepticum with one fluid ounce of warm water, say at 
115 F., and 4 drops acid hydrochloric c. p. (16 drops dilute 
acid U. S. P.). Apply by injection, spray, etc., as most 
suitable. 

FAIRCHILD'S PEPSIN 

AS A SURGICAL SOLVENT. 

Mix 5 grains of Fairchild's pepsin in powder perfectly 
smooth with a teaspoonful of water, then add an ounce of 
warm water, stirring well. Add 4 drops acid hydro- 
chloric c.p. and apply as required. 

EXTRACTUM PANCREATIS 

AS 

A SURGICAL SOLVENT. 

Mix in any convenient glass, 5 grains Extractum Pan- 
creatis to each fluid ounce of warm water, first carefully 



90 

stirring the powder with a teaspoonful of the water, to a 
perfectly smooth mixture. At the option of the surgeon, 
soda bi-carbonate, about 5 grains to each fluid ounce, 
may advantageously be added. 

It is by no means essential that these or any arbitrary 
proportions shall be observed. These quantities specified 
can be readily approximated without weighing. If it is 
found desirable to write a prescription for the solvents, 
the following formulas will be found satisfactory : 

IJ Glycerinum Pepticum 2 fl. ozs. 

Acid Hydrochloric c.p 64 minims. 

Aqua-Destillata 6 fl. ozs. 

My S. Pour the quantity necessary for each application 
into an equal quantity of water, heated to about 115 F., 
or as hot as can be borne by the whole hand and apply as 
directed. 

1$ Extractum Pancreatis 3 drs. 

Soda Bi-carb 1 dr. 

My Divide in wax papers No. 12. 

Mix one powder with a gill of warm water and prepare 
fresh for each application as directed. 

In preparing these solvents with water, it is well to 
use that which has been well boiled or distilled. 

1$ Extractum Pancreatis 1 dr. 

Soda Bi-carb 15 grains. 

My Divide in wax papers No. 12. Apply dry as directed. 



91 



FAIRCHILD'S 

Peptogenic Powder and Process; 

ITS DEVELOPMENT AND RATIONALE. 



It is now more than seven years since we introduced a 
method of preparing an imitation of woman's milk, based 
upon the agency of a digestive ferment in effecting the 
physiological conversion of the caseine of cows' milk into 
the soluble and diffusible form, in which the albuminoids 
exist in human milk. 

This purely physiological action of the digestive fer- 
ment can be controlled or checked at will by regulating the 
temperature to which the ferment is subjected. Under 
favorable conditions, the ferment acts until its power is 
spent; by simply raising the temperature of the digesting 
mixture to about 160 F., it is instantly destroyed and 
thus becomes an inert substance, insignificant in amount 
and resembling in chemical and physiological properties 
so much albumen. 

The digestive ferment has no other action, no proper- 
ties at all comparable to those of a drug or chemical. 

The pancreas ferment, trypsin, has a remarkable affinity 



92 

toward milk, digesting its caseine with great rapidity with- 
out altering its other elements and without rendering the 
milk repulsive. Milk so treated is known as " peptonised 
milk " and as made available by the Fairchild products and 
process, has long since become the chief reliance of the 
medical profession as supplying an ideal food for the sick. 

The value of peptonised milk was immediately recog- 
nised as a resource for the feeding of an infant with natur- 
ally feeble or disordered digestion, and experience only 
confirmed the promise of its great usefulness. 

After some years of practical experience with the pepto- 
nising process, and seeing the great facility with which 
caseine could be brought to any desired degree of digestion, 
the idea occurred to us that this process promised the 
solution of the problem of preparing an adequate substitute 
for woman's milk; as opening the way for the qualitative and 
quantitative adjustment of cows' milk to a correspondence 
with human milk to a degree never before attempted. 

In order to prosecute the undertaking, we entrusted the 
necessary expert investigation to Dr. Albert R. Leeds, well 
known to have made especial study of the composition of 
human milk and of the infant foods. 

Dr. Leeds found that under the influence of the diges- 
tive ferment, the caseine could be so altered as to impart a 
new and peculiar property to the milk ; that the milk 
became in its physical characteristics, density, color, taste, 
and in its behavior with acids and with gastric juice, 
remarkably like mothers' milk. The albuminoids of this 
converted milk under analysis showed a close resemblance 
to the albuminoids of woman's milk, thus adding a final proof 
to the theory that the differences in the physical properties 
and in the behavior^and d : gestibility of cows' and human 
milk, are directly dependent upon the character of their 
albuminoids. 



93 

Here then was an agent for the physiological conversion 
of the caseine, an expedient far more effective, natural and 
convenient than any hitherto devised, and which made 
possible the construction of an artificial human milk, by 
carrying out the further important modifications indicated 
by the results of comparative analysis. 

As a final result, we were able to offer the Peptogenic 
Milk Powder and method which were found by Dr. Leeds, 
as stated in his report, " to yield a \ humanised milk ' which 
in physical characteristics and chemical constitution 
approaches very closely to woman's milk." Thus we intro- 
duced a method of preparing a substitute for mothers' 
milk, which is the direct result of scientific study and investi- 
gation and which fairly represents the present status of 
knowledge and attainment ; the only food for infants which 
in its development and accomplishment, conforms to the 
universally accepted postulate that the best artificial food 
for an infant is that which in the highest degree resembles 
mothers' milk. 

Now after seven years of practical experience, study and 
investigation since its introduction, during which time we 
have had abundant means of ascertaining the results of its 
actual use as an exclusive substitute for mothers' milk, we 
feel the strongest conviction that it affords an artificial food 
for infants which is entirely adequate for the nourishment 
and development of an infant during the nursing period. 
We have, during these years, given unremitting investiga- 
tion in every direction which might enable us to attain the 
utmost perfection of detail in the approximation to the 
natural food of an infant. 

We submit the Peptogenic Powder and method solely 
upon this ground, — as a scientific, practical and successful 
method of modifying cows' milk to the known composition 



94 

of human milk. Upon this ground, we ask the considera- 
tion of every physician interested in providing food for 
infants deprived of breast milk. 

THE POINT OF VIEW ON INFANT FOODS. 

In infant feeding, as in many other subjects, scientific 
standards are in advance of practical usage. So whilst 
everywhere it is premised that mothers' milk is the best 
food for an infant, we see that foods which are wholly made 
up of substances foreign to milk, foods which were never 
designed to resemble human milk, continue to be bought 
and used without a question as to how they resemble the 
food for which they are to be substituted. 

We ask the physician therefore to submit the infant 
foods of the shops to the practical point of inquiry. How 
do they resemble mothers' milk when prepared for the 
nursing bottle ? No " infant food " as it is found in com- 
merce, resembles mothers' milk, or can take the place of it. 

The " infant foods " of commerce may be fairly divided 
into two distinct classes : 

First — Those which do not contain any milk and which 
are to be made ready for the nursing bottle by admix- 
ture with cows' milk. 

Second — Those which contain milk, the dried and condensed 
milk foods, all of which are directed to be prepared for 
the nursing bottle simply by the addition of waters 

When mixed for use according to the "directions" of 
the manufacturer the "infant foods" differ from human milk 
obviously in physical properties, and by analysis will be 
found invariably deficient in milk fat, milk sugar and milk 
salts, which deficiency is not by any means compensated 
for by the malt sugar or baked flour which imparts thick- 
ness and sweetness to the food. 



95 

Another important question is : — Shall we use fresh 
milk or commercial milk products as the basis for the prepa- 
ration of an infant food ? 

From our standpoint, we can at present find no other 
basis than fresh milk, for we have not thus far found that 
milk can be so treated as to afford a stable commercial pro- 
duct, from which a close approximation to mothers' milk 
can be prepared. 

We hold to the view that milk is materially altered by 
drying. That it will not on the addition of water, have re- 
stored to it even the physical characteristics of the original 
milk ; that the dried caseine of the milk will not again dis- 
solve in the water ; that the milk fat cannot be dried 
successfully ; that it will in this state, soon become rancid. 

It has for these reasons never been found possible to 
dry pure unskimmed milk as a marketable product, even 
for ordinary culinary and dietetic purposes. 

Milk condensed without sugar or other preservative has 
been found apt to spoil quickly after the package is opened. 
Sweetened condensed milk contains a large amount of cane 
sugar and when such milk is diluted with the proper 
amount of water, it is much too sweet and thick. It is in 
common practice diluted so as to be greatly deficient in the 
real elements of milk. 

COWS' MILK AS A FOOD FOR INFANTS. 

In seeking a food for an infant deprived of breast milk, 
cows' milk has been instinctively resorted to as the sub- 
stance nearest to it in apparent properties and design. But 
notwithstanding these similarities, cows' milk has proven 
inherently indigestible for the infant stomach and inade- 
quate to replace woman's milk. Hence the problem of infant 
feeding. Hence the infant foods of commerce. Finding 
that cows' milk forms an indigestible curd, various expedients 



90 

have been employed to overcome this. Among these, is 
the use of an alkali such as lime water, to form soluble 
or alkaline albuminates, to give the milk an alkaline reaction 
and also to retard the curdling action of the gastric juice. 

The most familiar and common method has been to 
thicken milk with baked flour, or farinaceous foods — to 
keep the curds from forming a mass. But the effect of 
these substances is purely mechanical, they do not alter 
the character of the caseine, they " thicken," but do not 
enrich milk. It is simply adding a new difficulty without 
overcoming the original one. 

Liebig, seeing that starch was not suited to an infant's 
digestion, that the nursing infant is not endowed with the 
power to digest starch, proposed to utilise the starch digest- 
ing ferment of malt — its diastase — for the artificial diges- 
tion of starch. Thus he gave us the method of treating 
wheat flour with a fresh infusion of malt and bicarbonate 
of potash, by which the starch is dissolved and converted 
into malt sugar. This, in brief, is the origin of the Liebig 
foods, by which we are now supplied with a ready-made 
malted or digested flour for addition to fresh milk. 

But there being no starch nor digested starch (maltose, 
dextrins, etc.) in milk, human or animal, whilst there is 
in all milk found available a sugar peculiar to milk alone, 
there remains neither reason nor necessity for giving starch 
or digested starch to the nursing infant. 

Therefore, from the standpoint of to-day,Liebig's method 
cannot, on theoretical grounds, be considered to afford an 
approximation to mothers' milk, nor has it in long practical 
experience proven a solution of the problem of infant 
feeding. 

In the futile attempt to overcome the indigestibility of 
caseine, milk has often been so diluted as to render it in- 
capable of properly nourishing an infant. The addition of 



9? 

Water does not alter the character or behavior of caseine. 
Many in diluting the milk, have added nothing to attempt 
to compensate for the dilution of the sugar and the fat, — 
at the beginning deficient in quantity. 

Such in brief, are the methods long in practice for the 
preparation of fresh cows' milk for infants. So that whilst 
the selection of animal milk for the bottle feeding of infants 
has been dictated by its resemblance to the natural food, 
we have gone on adding to it, substances foreign to all milk 
and unsuited to the digestive functions and nutrition of an 
infant. 

It has taken us a long time to get to the present stand- 
point, that "an infant food approaches perfection in the 
degree in which it resembles human milk." 

If many infants have, by virtue of superior resistance, 
been capable of appropriating sufficient nourishment from 
cows' milk in the various forms, how many have perished 
by artificial feeding ! It is not here necessary to "make a 
case " in order to offer a remedy. 

COMPARATIVE COMPOSITION OF COWS' AND 
HUMAN MILK. 

Modern chemical and physiological investigation clearly 
reveals the reason why cows' milk is not suitable for the 
human infant. We see the significance of the difference 
found to exist in the composition of human and cows' milk, 
— that the milk of each is peculiarly adapted for the purpose 
for which it is designed. We now know that cows' and 
human milk differ in the total quantity of nutritious mate- 
rials and in their relative proportions. Cows' milk contains 
less total solids, less fat, less milk sugar and twice as much 
albuminoids. In cows' milk, there is a larger proportion 
of the element of nutrition which creates and supports 



98 

muscular energy and activity ; in human milk there is & 
larger proportion of sugar and fat. 

Breast milk is uniformly and persistently alkaline. 
Cows' milk is more or less acid, and its acidity becomes 
more and more marked by keeping. 

In cows' milk the greater part of the albuminoids is 
caseine, the substance which is curded by rennet and pre- 
cipitated by acid — the cheesy portion. 

In woman's milk the greater part of the albuminoids 
exists in a soluble or peptone-like form, which is incapable 
of coagulation or precipitation. The small fraction that is 
coagulable gives with acid or gastric juice minute, mobile, 
flocculent particles. 

Thus it appears that in cows' milk there is not only a 
preponderance of albuminoids, but their quality is such as 
to demand a degree of digestive power to which the infant 
organism is unequal. 

Milk is a vital secretion, and human milk the more 
highly elaborated, in its digestibility and its nutritive 
qualities, in conformity with the requirements of the highly 
organised being for whose nutrition it is destined. 

It is the caseine, therefore, which has proven the obsta- 
cle to the practical employment of milk as a food for infants, 
for the sugar and the fat of milk exist in a form ready for 
absorption — and in a form peculiar to milk alone. 

THE USE OF THE PEPTOGENIC MILK POWDER 

FOR THE PREPARATION OF " HUMANISED 

MILK" INVOLVES THREE 

DISTINCT STEPS : 

First — To prepare with Peptogenic Powder, cows' milk, water 
and cream, a mixture which has the quantitative compo. 
sition of average human normal milk. 



99 

Second — To subject this mixture to the action of the diges- 
tive principle by which the albuminoids (caseine, etc.) 
are converted into such form as to become identical 
with those of human milk. 

Third — To then destroy the digestive ferment by simply 
raising the temperature of the milk to the boiling 
point. This heat also destroys the bacteria and ren- 
ders the milk practically sterile during the time 
required for use — 24 hours. 

DIRECTIONS FOR " HUMANISED MILK." 

No. 1. 

FOR THE DAILY FOOD OF A HEALTHY NURSING INFANT. 

Put into a clean granite ware or porcelain lined saucepan, 
four small measures*, or one large measure of the Peptogenic 
Powder, half pint of cold water, half pint of eold fresh 
milk, and four tablespoonfuls of cream. Place the sauce- 
pan on a hot range or gas stove and heat with constant 
stirring until the mixture boils. The heat should be so ap- 
plied as to make the milk boil in ten minutes. 

Keep in a clean, well-corked bottle in a cold place. 
When needed, shake the bottle and pour out the desired 
portion and heat to the proper warmth for feeding — luke- 
warm. 

No. 2. 

SPECIALLY PREPARED FOOD FOR INFANTS WITH FEEBLE 

DIGESTION OR WHEN SUFFERING FROM DISORDERED 

STOMACH AND BOWELS, AS IN CHOLERA 

INFANTUM, ETC. 

Put into a clean bottle, four small measures*, or one large 
measure of the Peptogenic Powder, half pint of cold water, 
half pint of cold, fresh milk and four tablespoonfuls of cream. 

* Each large can of Peptogenic Milk Powder contains a large and a small 
measure. Put the Powder into the measure with the blade of a knife, shaking k 
down firmly so as to well and evenly fill the measure. 

The small can contains the small measure only. 



100 

Shake well, place the bottle in a pail or tin kettle of water 
(at least a gallon) as hot as can be borne by the whole hand 
(115 F.), and keep the bottle there for 30 minutes. 
Then pour all into a sauce pan and quickly heat to boiling 
point with constant stirring. 

Keeping and feeding in the same way as directed in 
No. 1. 

COMPOSITION OF " HUMANISED MILK." 

" Humanised milk " contains the amount of milk sugar, 
fat, albuminoids, ash and water found in mothers* milk. It 
possesses the peculiar alkaline reaction due to the proper 
proportions of those various mineral and saline constituents 
which are always normally present in woman's milk, and 
which ar^essential elements in the nutrition of the infant, 
being vitally necessary to the development of its osseous 
system. It resembles mothers' milk remarkably in its 
physical properties, and under every known method of test, 
it is found to behave in the manner characteristic of aver- 
age normal breast milk. 

We do not advise varying the proportions according 
to the age of the child. In the careful study of the facts 
brought out by the many analyses now extant of woman's 
milk, made during the entire period of lactation, there does 
not appear a sufficient variation in the quality of the milk, 
or in the ratio of its constituents, to afford a practical 
ground for making any variation in an artificial food. 

It may logically be assumed therefore, that the average 
composition of human milk is the most practical and scien- 
tific basis for the fabrication of a food for the average 
infant, permitting the bottle-fed infant, like the nursing 
infant, to take food in such quantities and at such inter- 
vals as best conduces to its health. 



101 
DIGESTIBILITY OF "HUMANISED MILK." 

"Humanised milk" presents to the infant's stomach a food 
which requires the same exercise of the natural digestive 
functions as required for mothers' milk — the caseine has 
undergone no greater amount of artificial digestion than is 
necessary to bring it to the soluble condition characteristic 
of the albuminoids of mothers' milk. It is not in the least 
giving a milk unnaturally easy of digestion. There enters 
the infant's stomach no artificial aid to digestion, no pep- 
sin, no digestive ferment of any kind ; for after the ferment 
has accomplished a certain work in the conversion of the 
caseine, it is then destroyed and has no further influence 
upon the food — has nothing more to do with the digestion 
of the milk in the stomach than has the fire by which the 
milk was heated. 

HOW TO ADAPT THE MILK FOR INFANTS 
WITH FEEBLE DIGESTION. 

In order to adapt this " humanised milk " to the stomach 
of an infant with naturally feeble digestion, or with diges- 
tion disordered by teething, summer complaint, etc., the food 
is not to be specially diluted, it is simply necessary to reg- 
ulate the degree of conversion of the caseine to insure its 
digestion and assimilation. This is accomplished by leav- 
ing the milk for a longer time at the temperature suitable 
for the action of the ferment before boiling the milk. 
Therefore in directions No. 2, we direct 30 minutes in the 
warm water bath before bringing the milk to the boiling 
point. In extreme cases, the caseine may be, by longer 
digestion, (40 to 50 minutes) so converted into a soluble 
form that the milk becomes capable of absorption with- 
out the least tax upon the stomach. 

As the child recovers strength, the degree of this 



102 

conversion is gradually decreased until it is able to assimi- 
late milk which has the digestibility of mothers' milk.. By 
this means a sick infant is not deprived of nutrition in the 
attempt to find a food which it can tolerate. 

There is also another expedient which has been found 
successful in the many cases of infants who seem to have 
practically no digestive power. This is to give the 
" humanised milk " containing the ferment in an active form 
and thus capable of effecting the subsequent changes of 
the food essential to its assimilation. Mix the Peptogenic 
Powder, water, milk and cream in the regular proportions, 
cold) then place the bottle directly on ice. When required, 
shake well, pour out only the necessary quantity and heat 
carefully over a flame until it is just warm enough for the 
nursing bottle. Do not boil it and do not let it get hotter 
than is agreeable to the mouth. This method should 
always be used when the food by Directions i or 2 is not 
properly assimilated by the infant. After the child has 
become strong enough, then gradually return to Directions 
No. 1. 

CHOLERA INFANTUM. 

The Peptogenic Milk Powder is too often brought first 
into use in a case when the infant is suffering from cholera 
infantum or from severe disturbances of digestion, aggra- 
vated by improper food and the system weakened by lack of 
nutrition. Even in such cases, relief is often immediately 
found in the administration of the specially prepared 
"humanised milk." (See directions No. 2). Give very slowly 
and in very small quantities at each feeding. But many 
times the case presents the entire alimentary tract in a 
condition highly favorable to the fermentation of milk and 
equally unfavorable to its absorption. Hence, milk may 
add fuel to fire. 



loa 

In consequence of these facts it has become the prac- 
tice to discontinue milk entirely for a time, in the endeavor 
to give rest to the digestive functions and to promote the 
effects of the purely medicinal measures. The difficulty 
here is to find a substitute for milk which will afford 
adequate nutrition. 

WHEY AS THE TEMPORARY FOOD IN 
CHOLERA INFANTUM, ETC. 

We strongly recommend " Whey " as affording by far 
the most satisfactory temporary food in Cholera Infantum. 

This opinion is based not only upon its composition, 
but also upon some seven years of practical experience of 
its use. Whey contains, in a greater or less degree, every 
element of nutrition and in a perfectly assimilable form. 
It contains the soluble albuminoids, milk sugar and saline 
constituents of the milk. It is thus not giving a diluted 
milk. The milk has only been deprived of its caseine and 
the greater portion of its fat. Whey is therefore unques- 
tionably far more suitable for the nourishment of a child 
than beef juices, beef foods, etc., or any other food which has 
ever been suggested as a temporary substitute for milk. 
As prepared with Fairchild's Essence of Pepsine, it is not 
only most palatable, but the contained Essence is also of 
great value as a remedy. For very young infants, it should 
be prepared with one teaspoonful of Essence to a pint of 
warm milk. For older infants it may be prepared with a 
teaspoonful to a half pint of milk and thus the proportion 
of the Essence of Pepsine may be made available for its 
remedial properties in conjunction with the whey. The 
Essence of Pepsine is accompanied by simple directions 
for the preparation of whey. Whey should be given 
from the nursing bottle, like the ordinary food. 



104 

The Essence of Pepsine affords the ideal digestive and 
carminative stimulant for disorders of infant digestion. It 
is generally given in 5 to 10 drop doses in a teaspoonful 
of pure water or with a teaspoonful of the whey or 
"humanised milk.'' 

HOW LONG SHOULD THE BABY BE FED ON 
" HUMANISED MILK." 

Only that food is a proper substitute for breast milk 
which is capable of the nutrition of an infant during the 
entire nursing period. "Humanised milk," being equivalent 
to average healthy breast milk, should be the exclusive 
food of an infant just as long as it would ordinarily take 
breast milk. The soundness of this theory and this 
practice has been proven by experience — by results. 

It is found that there is a disposition on the part of 
parents to hurry the child along to what they fancy to be 
a "richer" food, to milk "thickened" with prepared foods, 
etc. To which we reply that " humanised milk " is not de- 
ficient in any element for the perfect development of an 
infant, that it is as rich as human milk, and richer than 
cows' milk in every constituent save the caseine ; that 
mothers' milk ought to be the safest standard for a food 
up to the time of weaning. 

HOW TO WEAN THE BOTTLE-FED BABY. 

An infant should be weaned from the bottle gradually 
just as from the breast. At an age at which a nursing 
child would ordinarily be given a little oatmeal, hominy 
or rice, the bottle-fed infant should be given these fari- 
naceous foods. 

Begin with one feeding a day of well boiled oatmeal or 
rice, or some well baked potato mixed with " humanised 
milk/ 5 Feed with a spoon. Increase gradually to several 



105 

times a day, or until the bottle is no. longer required. Now 
begin to prepare the food with ordinary pure fresh cows' 
milk instead of with the " humanised milk" until you accus- 
tom the child to live entirely upon pure milk and farinaceous 
foods. But the less meat the better, until the child is two 
or three years old, say many of the physicians most expert 
in infant feeding. 

" HUMANISED MILK" 

AS A PARTIAL SUBSTITUTE FOR BREAST MILK. 

In many cases it is found desirable or necessary to 
resort to bottle-feeding as a partial substitute for breast 
milk; here the "humanised milk" is the only food which 
can be properly given. 

It is so identical with pure breast milk that no injury 
results to the child, it is taken as readily as the breast 
milk, and this alternate feeding produces no disturbance 
of the digestive functions. It is so much better than faulty 
breast milk, that it is often of the greatest value, both to 
the infant and mother to resort partially to a food which 
properly nourishes the child and relieves the mother of an 
undue tax upon her strength. No good result can come 
from compelling a child to take several times a day, thick, 
sweet malt sugar or starchy food, foods which load and 
distend the stomach, and the rest of the time the thin, di- 
gestible fluid — mother's milk. 

Many a mother would gladly and profitably be relieved 
in a measure of the strain of nursing, if it could be 
accomplished without prejudice to the child, and this can 
be done by means of "humanised milk." 

"HUMANISED MILK" HAS NO SPECIAL EFFECT 
UPON THE BOWELS. 

The "humanised milk" has no especial tendency to 
produce either costiveness or looseness of the bowels. 



106 

Either one of these conditions may appear according to 
the constitution of the child or as dependent upon various 
reasons, just as may occur when taking breast milk. 
Sometimes — especially in hot weather — an infant requires 
water to keep its bowels in good order and for its well 
being in general. A little calcined magnesia or a little 
flake manna dissolved in the milk when ready for feeding, 
is a good remedy for constipation. Or use oatmeal water 
in place of plain water in preparing the " humanised 
milk." Take one table-spoonful of thoroughly cooked 
oatmeal (as ordinarily prepared for the table) and stir 
well into half a pint of hot water ; strain. Constipation is 
sometimes immediately relieved by heating the milk to 
170 F. instead of to the boiling point ; this lower tempera- 
ture is equally effective in killing the digestive ferment 
and in sterilising the milk.* Hold the fresh milk mixture 
in a saucepan over a flame, stirring constantly till it is 
heated to 130 F., then place over the flame again and 
stir constantly till the milk reaches 170 F. — the whole 
process not to take more than 10 minutes. Then pour 
the milk into a clean, well corked bottle. 

One of the most simple and frequently effective expe- 
dients for loose bowels is to thicken the milk for a few 
feedings with thick arrowroot gruel, made by mixing the 
arrowroot with cold water and then boiling it for a long 
time till very smooth and well cooked. The so prepared 
gruel is to be added to the " humanised milk " when it is 
ready for feeding to the child. Its use should only be 
continued for a few feedings until the trouble is remedied. 
Colic, loose bowels with flatulence, are greatly relieved by 
the use of Fairchild's Essence of Pepsine given in from 5 
to 10 drop doses in a teaspoonful of water just before 

* For this purpose buy the cheap dairy thermometer, all glass and 
plainly marked to 170 F. 



107 

feeding. It may be so given several times during the day, 
but not continued beyond the necessity for its use. If 
there is persistent diarrhoea, it is a case for the physician ; 
it requires skilful medical treatment. 

"CHANGING THE FOOD" 

AS AN EXPEDIENT IN GETTING ONE THAT WILL AGREE. 

It must be held that having a food equivalent to 
mothers' milk, we should use it like mothers' milk and 
as far as possible treat all variations of function and dis- 
turbances of health just as we would if the child were 
taking breast milk. 

In the average healthy infant, fed from birth upon 
"humanised milk," there is as little probability of digestive 
disturbances as from breast feeding. Indeed, the " human- 
ised milk," is often advantageously substituted for faulty 
breast milk and successfully alternated with healthy breast 
milk. But the difficulty is that foods are for the most part 
selected (?) hap-hazard — the food which "sells the most," 
or is the most advertised, or the food upon which a 
friend's child has been brought up, etc. The result we see 
is that in numberless instances coming to our knowledge, 
it is a history of one food after another, as many foods 
sometimes as the infant is months or even weeks old. 

These cases present the utmost difficulty when medical 
advice is finally sought ; every possible variety of compli- 
cation is encountered. In these cases, even good breast 
milk would not at once be successful. 

An infant accustomed to the unnatural distention, 
irritation or stimulus to the alimentary tract from the 
presence of bulky, thick, insoluble "farinaceous" foods, 



108 

or u milk foods " composed of dried milk and baked flour — 
in which both caseine and starch are in a practically 
unassimilable form, will not immediately adapt itself 
perfectly to a thin food like mothers' milk. If the entire 
mucous membrane is in a catarrhal condition, even breast 
milk itself would undergo ulterior change before it could 
be absorbed. It is a question of therapeutics as well as 
of food. 

From the use of such empirical foods and empirical 
feeding has come the dictum, sometimes uttered " No 
food suitable for all cases — all foods must be tried." 
There is something superficially attractive about this 
proposition, but has it any place in a rational, scientific 
system of infant feeding? Too much insisted upon, does 
it not make any food good enough to sell ? Is it not a 
palpably empirical standpoint ? To what purpose then 
the comparative study and analysis of animal milk, and of 
the method of approximating it to the composition of 
human milk ? Of what significance then, the theoretically 
accepted and unassailable postulate that mothers' milk is 
the standard of perfection? 

Whatever part food in all its varieties plays in the 
therapeutics of infant feeding, there can be no escape 
from the logic of the proposition that the food practically 
identical with mothers' milk should be the food chosen for 
the artificial nourishment of an infant from birth. 

Such a food is yielded by the Peptogenic Milk Powder 
and as such, it deserves the wide and general use so long 
given to empirical foods — to foods palpably unlike mothers' 
milk in physical characteristics and widely dissimilar in 
chemical composition. 

It is often said that there are infants who will live on 



109 

anything and there are certainly also many with constitu- 
tions so feeble, so prone to disease that no care avails to 
succor. Whilst the empirical foods are used as broadcast 
as they are advertised and thus largely for average 
healthy infants, the " humanised milk " finds principal use 
in cases brought to the attention of the physician after 
failure with a variety of foods. 

Peptogenic Milk Powder is the most successful food for 
sick and feeble infants, simply because it is the most 
like mothers' milk and it is the best food for healthy infants 
for the same reason. Why should the best food be selected 
only for the sick and feeble infant, the best food is the 
right food for the healthy infant also. " Just as the twig is 
bent the tree's inclined/' and it is difficult to exaggerate 
the influence of proper feeding in the development and 
future health of the child. 



RICH MILK— FROM ONE COW. 



The formula and process for the preparation of " human- 
ised milk " given, is based upon results obtained with ordi- 
nary, fresh cows' milk, as supplied by reputable dealers in 
all large cities. With this milk the best results are in prac- 
tice obtained, both in the behavior of the milk with the 
Powder, and as a food. But we find that people are apt to 
obtain, when possible, the milk of rich Alderney cows, or 
one cow's milk. With this milk there is very apt to be 
trouble. It is not nearly so readily approximated to human 
milk as the ordinary mixed cows' milk. The richness of 
such milk is valuable when it is concerned in cheese mak- 
ing, but quite the contrary in preparing milk for a bottle 
fed infant. We believe that our views and our experience 



110 

in this particular are in accordance with the best medical 
opinion at the present time. 



CREAM. 



The use of cream is not an indispensable condition to 
the employment of the Peptogenic Milk Powder. It is nec- 
essary with this as with every other food if we wish to get 
the amount of fat contained in human milk. 

The use of cream is urgently advised. It should not 
be dispensed with upon an impression (for which there is no 
foundation in fact) that the cream is " too rich " for a child. 
A certain proportion of fat is provided in the natural food 
of an infant, and in a condition ready for absorption. It 
sustains important functions in the digestive process of an 
infant aside from that of nutrition. 

" Skimmed milk" forms a peculiarly firm and tough 
curd — " hickory curd " as it is called. The presence of 
the cream undoubtedly aids the digestibility of milk, 
especially for infants. It gives mobility and softness to the 
curds, preventing the aggregation of large impenetrable 
masses. It is a significant fact that whilst every " infant 
food " sold, or the food as prepared with them, is deficient 
in cream, the use of cream is not directed except in the 
Fairchild process. 

If it is found inconvenient to use cream, it is better 
to use the Peptogenic Milk Powder without cream than to 
resort to some other food, not only deficient in cream, but 
deficient and inferior in other respects also. 



Ill 

THE TEMPERATURE OF THE WATER BATH. 

The object of the immersion in the water bath, in 
Directions No. 2, is to bring the milk (in the bottle) to about 
blood heat conveniently and without risk of over-heating. 
The water in the "bath " should be about 115 F. 

The average temperature tolerable at which the whole 
hand can be immersed in water for one minute is about 
115 F. It is seldom that any person can endure it more 
than a few degrees hotter. This expedient is, therefore, 
convenient and reliable for ascertaining the proper temper- 
ature of a vessel of water. Those who prefer may use the 
ordinary thermometer, "Dairy thermometers " or "bath 
thermometers," just the thing, may be purchased for a 
small sum. 

The pail used for the hot water bath should hold a 
sufficient quantity of water to come up above the mixture 
in the bottle. It is not meant that the pitcher or pail of hot 
water containing the bottle of milk should be set in a warm 
place with the purpose of maintaining the same heat as 
started with. The water bath should stand in any con- 
venient place at ordinary temperature of the room. 

MILK TASTES BITTER. 



" Humanised milk " properly prepared by the regular 
Directions No. 1 will not taste bitter ; the milk may 
become bitter if it is too slowly heated to the boiling — 
as for instance, over a low fire. To avoid bitterness, in 
Directions No. 2, it is simply necessary to reduce time in 
water bath and to boil quickly. 



112 

In preparing the milk for cases of cholera infantum 
and cases of exceedingly feeble digestion, it is often 
desirable to digest the milk thirty minutes or so before 
boiling it. This milk (Directions No. 2) may taste bitter 
because of the very complete digestion of the caseine ; 
but it is seldom refused by the infant, and if so, it may be 
sweetened with milk sugar, which may be bought of the 
druggist. 

MILK CURDLED WHEN BOILED. 

If a fine, granular curd appears in the " humanised 
milk " when it is mixed and boiled according to directions, 
it is because the milk is stale, or is too rich, or has not 
been mixed with the full amount of water. If the milk is 
fresh and is fit for use and has been properly diluted, 
it will not curd. 

We find that people are apt to leave out the proper 
amount of water, because they think it is "too much." 



THE USE OF CONDENSED MILK WITH 
PEPTOGENIC MILK POWDER. 

Milk deprived of a definite proportion of water by 
evaporation, should theoretically become again like cows' 
milk in composition, by the addition of water. But in prac- 
tice the condensed milks of commerce do not meet these 
anticipations. They cannot replace fresh whole milk as a 
basis for " humanised milk." We find no reason to recom- 
mend condensed milk when ordinary fresh milk is obtain- 
able. Sweetened condensed milk should never be used ; 



113 

it contains a large amount of cane sugar. The best con- 
densed milk is usually not more than four times the 
strength of pure milk. 

If it is absolutely necessary to use condensed milk, one 
part of pure unsweetened milk should be first mixed with 
from two and a half to three parts of water, and may 
then be presumed to be equivalent to cows' milk. Then 
to 8 ounces of this mixture add 8 ounces of water and the 
cream and Peptogenic Milk Powder in the usual manner. 
In other words, we first require to dilute pure, unsweetened 
condensed milk with about 7 parts of water, and to each 
pint of this diluted milk should be added 4 tablespoonfuls 
of cream and one large measure of the Peptogenic 
Powder and treated in the usual manner. 

STERILISED MILK. 

Sterilised milk has recently attracted much attention 
as a food for infants and as the basis of a food. 

The sterilisation of milk has been advocated for the 
following reasons, viz. : — That milk in the udder contains 
no germs ; that the suckling is presumed to receive from 
a healthy source germless milk. 

But normal sterile milk and sterilised milk differ in 
very significant particulars — one is a product of nature, the 
other accomplished by prolonged subjection to boiling 
under pressure. 

Presuming that the process of sterilisation has been 
successfully conducted, and presuming that no other 
change has been produced by the sterilisation, theoretically 
sterilised milk precisely resembles pure, germless cows' 
milk. 



114 

But it is important to investigate the effects really pro- 
duced upon cows' milk by the process of sterilisation, by 
boiling milk in a flask excluded from air for 30 to 45 
minutes. 

As a matter of fact, important changes are produced 
in the milk by this treatment. It is found that the 
amount of coagulable albumen is increased, that the milk 
is altered in its properties, and in its behavior and that 
these changes altogether indicate that milk is rendered 
more indigestible by sterilisation. The result of expert 
chemical investigation of sterilised milk at the present 
time may be said to be decidedly unfavorable to it as a 
substitute for breast milk. 

By sterilisation, the ratio or sum of nutritive constitu- 
ents of milk is not changed ; its constituents are not 
in any degree brought to a greater resemblance to those 
of human milk. 

Having, during the past few years, made careful and 
repeated examinations of sterilised milk, and with very 
considerable opportunities of becoming acquainted with 
the results of its practical use as a food for infants, we 
are unable to recommend sterilised milk. In fact, we have 
felt constrained to advise our correspondents against its 
use. One of the characteristic experiences reported has 
been that sterilised milk often proves incapable of afford- 
ing adequate nourishment, especially for infants with im- 
paired digestion. Such infants, although frequently fed 
with sterilised milk and in ample quantity, do not thrive, 
and evince a constant craving for food. Furthermore, 
the process for the use of Peptogenic Milk Powder, in 
which w T e recommend that the milk be brought simply to 
the boiling point, practically renders the milk sterile, free 
from germs and entirely suitable for the food of an infant 



115 

for the length of time in which it is required, twenty-four 
hours or more. Even a much lower temperature, 160 to 
170 F., is perfectly effective for all practical purposes ; 
it kills the germs and kills the digestive ferment and con- 
sequently checks digestion. This temperature was pro- 
posed by Pasteur for the destruction of germs and the 
preservation of foods, and the process, as practically 
employed, is known as Pasteurisation. We have found 
that milk so prepared with the Peptogenic Powder and 
" Pasteurisation " will keep for 24 hours or more without 
change, simply corked in an ordinary bottle. We have 
very often had occasion to recommend this method as a 
substitute for sterilised milk, and with perfect success. 
There remains consequently no necessity whatever for 
submitting milk to the sterilising process. In this opinion, 
we believe that we have the concurrence of all experts, 
both chemists and physicians, who have given careful in- 
vestigation to this subject. 



Average of An- 
alyses 80 
Samples of 
Woman s Milk. 



116 
Hoboken, N. J., June 14, 1884. 
Water. Fat. Milk Sugar. Albuminoids. Ash. 

86.73 4.13 6.94 2. 0.2 



Analysis 
"Humanised 

Milk," as made) 86.2 4.5 7. 2. 0.3 

with Peptogenic\ 
Milk Powder. 



April 1st, 1891. 
Messrs. Fairchild Bros. & Foster. 

Dear Sirs : 

It is now some seven years since I made my 
original report to you, in which I stated that I found the 
Peptogenic Milk Powder to yield a "humanised milk, 
which in taste, physical characteristics and chemical con- 
stitution approaches very closely to woman's milk." 

During this time, I have at frequent intervals analysed 
the humanised milk as prepared with the Peptogenic 
Powder ; have made many analyses of milk and of " infant 
foods," and have studied the various methods of treating 
milk for the artificial feeding of infants. As a result of 
this experience, I feel confirmed in the conviction that the 
Peptogenic Milk Powder with the method given is the 
most exact, natural and practical means at present known 
of rendering cows' milk suitable as a comprehensive 
substitute for woman's milk. 

Yours truly, 

ALBERT R. LEEDS, Ph.D. 

Professor of Chemistry, Stevens Institute of Technology. 
Hoboken, N. J. 



117 
PRACTICAL RECIPES 

FOR 

PEPTONISED FOODS FOR THE SICK, 

MILK, GRUEL, BEEF, OYSTERS, JELLIES, 

PUNCHES, Etc., 

BY THE FAIRCHILD PROCESS. 

These recipes are designed to facilitate the preparation 
of peptonised milk and other artificially digested foods. 
Their preparation requires only the simplest culinary uten- 
sils, and no more care or skill than that expended in mak- 
ing the ordinary foods for the sick, so long in vogue. 

Of their infinite superiority, not only as material for 
nutrition, but in adaptability for digestion by the sick, it is 
scarcely necessary to speak. 

Peptonised Foods are the chief reliance of the medical 
profession, both in private and hospital practice, for the 
feeding of the sick. And it is greatly to be hoped that 
the very fallacious ideas prevalent among the laity as to 
what constitutes a food for the sick, will, in spite of 
tradition and habit, give way to the more salutary and 
enlightened views now reached in the progress of medical 
science. 

The subject of nutrition is now recognised to be of 
first importance in the treatment of disease. The sick re- 
quire veritable food and digestible food. There are no 
" active principles " of food which can be extracted like 
alkaloids from drugs. By the Fairchild peptonising pro- 
cess foods which are found adequate for the nourishment 
of the healthy and vigorous may be adjusted to the func- 
tions of digestion enfeebled by chronic ailments, or wholly 
interrupted by acute diseases, fevers, etc. 



118 

THE NUTRITIVE VALUE OF MILK AS COMPARED 
WITH BEEF TEA, EXTRACTS OF BEEF, ETC. 

Milk contains sugar ready formed for absorption ; fat in a condition 
perfectly adapted for assimilation ; mineral substances essential to nutri- 
tion of the bony structure ; and a due proportion of albumen, or flesh form- 
ing element — caseine. 

One pint of milk contains over two ounces of actual dry, solid nutri- 
tious substance. 

" Beside the trifling amount of proteid material, and the fat (which lat- 
" ter is guarded against with great care) the beef tea then only contains 
** the salts of the muscle, the hematin and allied pigments, traces of 
" sugar perhaps, some lactic acid, and the nitrogenous extractives, creatin 
11 and its congeners. 

' ' As the original half pound of muscle will contain but forty to sixty 
"grains of salt, and ten to twelve of nitrogenous waste products, the 
" beef tea certainly contains no more." 

Prof. BAUMGARTEN, M.D. 

11 The valuation by most persons outside the medical profession, and 
11 by many within it, of beef tea or its analogues, the various solutions, 
" most of the extracts and the expressed juice of meat, is a delusion and 
44 a snare which has led to the loss of many lives by starvation. The 
" quantity of nutritive material in these preparations is insignificant or 
" nil, and it is vastly important that they should be reckoned as of little 
" or no value, except as conducive indirectly to nutrition by acting as 
" stimulants for the secretion of the digestive fluids or as vehicles for 
" the introduction of nutritive substances. Furthermore, it is to be con- 
" sidered that water and pressure not only fail to extract the alimentary 
" principles from meat, but the excrementitious principles, or the prod- 
ucts of destructive assimilation, are thereby extracted. A few years 
" ago, a German experimenter declared that he produced fatal toxaemia 
11 in dogs by feeding them with this popular article of diet." 

Dr. AUSTIN FLINT, Sr. 

So much then for this " strength " that so many people fancy they get 
out of the beef, by the maceration in cold water, simmering and boiling. 
How much less does the beef weigh than at the beginning ? 

It is the flesh that gives value to the beef, wherein it differs from fari- 
naceous foods. The flesh is not soluble in water. The water extracts 
some of the salts of the beef, some coloring matter, extractives, etc., and 
the now tasteless flesh is discarded. Beef tea, beef extract, is utterly 
incapable of properly nourishing the body in health or disease. Milk 
does supply every element of nutrition, the elements that are found in 
the most diverse forms of food. 



119 

RECIPES. 

PEPTONISED MILK. 

WARM PROCESS. 

Into a clean quart bottle put the powder contained in one of the pep- 
tonising tubes, and a teacupful of cold water, shake, then add a pint of 
fresh cold milk and shake the mixture again. Place the bottle in water 
so hot that the whole hand can be held in it without discomfort for a min- 
ute (or at about 115 F.). 

Keep the bottle there ten minutes. 

At the end of that time put the bottle on ice to check further digestion 
and keep the milk from spoiling. 

Place the bottle directly in contact with the ice. 

Ten minutes in the hot water-bath gives sufficient time for the 
predigestion of the milk in ordinary cases. 

If there is any evidence that the milk requires more digestion, it is only 
necessary to let the milk stand a longer time in the hot water-bath. 

COLD PROCESS. 

Mix the peptonising powder in cold water and cold milk, as usual, and 
immediately place the bottle on ice, without subjecting it to the water- 
bath or any heat. 

When needed pour out the required portion, and use in the same man- 
ner as ordinary milk. 

It is recommended to try the milk prepared by the cold process, in those 
cases in which food is not quickly rejected after ingestion, but in which the 
digestive functions are impaired, or even practically suspended. It has 
been found in many such cases that the peptonising principle exerts suf- 
ficient action upon the milk in the stomach to insure its digestion and 
proper assimilation. If the milk so prepared be not well borne, or any 
evidence appear of its imperfect digestion, it should be sufficiently pre- 
digested — peptonised — by the usual warm process. 

Milk by the " cold process " is especially suited for dyspeptics and per- 
sons who ordinarily find milk indigestible. This milk has no taste or 
evidence of the presence of the peptonising agent. 

PARTIALLY PEPTONISED MILK. 

Put into a clean granite ware or porcelain lined saucepan the powder 
contained in one of the Fairchild peptonising tubes, and a teacupful (gill) 
of cold water ; stir well, then add a pint of fresh cold milk. Place the 



saucepan on a hot range or gas stove and heat with constant stirring until 
the mixture boils. The heat should be so applied as to make the milk boil 
in ten minutes. When cool, strain into a clean bottle, cork well and 
keep in a cool place. When needed, shake the bottle, pour out the 
required portion, and serve cold or hot as directed by the physician in 
charge. 

JV. B. — Milk thus prepared will not become bitter. 

HOT PEPTONISED MILK, AS A BEVERAGE. 

Into a clean quart bottle put the powder contained in one of the Pep- 
tonising Tubes, and a teacupful of cold water, shake, then add a pint of 
fresh cold milk and shake the mixture again. Place the bottle on ice un- 
til the milk is required for use. When needed, pour the portion to be 
used into a saucepan and heat as hot as can be agreeably sipped. 

If required for immediate use, the peptonising powder, cold water and 
cold milk may be thoroughly mixed in the saucepan and heated to the 
proper temperature for drinking. 

At this temperature (during the heating) the peptonising powder acts 
with great rapidity, and in a few minutes a hot peptonised milk may be 
prepared which will be sufficiently digested for the majority of cases. 

Hot peptonised milk is the most grateful, nourishing and bracing bev- 
erage for invalids, dyspeptics, diabetics and consumptives. 

It is especially useful with breakfast, and at any time when suffering 
from a sense of exhaustion with an intolerance for solid foods. 

It is very acceptable to persons who require nourishment before sleep- 
ing and may be used at the table instead of ordinary milk with tea or 
coffee. 

EFFERVESCENT PEPTONISED MILK. 

Put some finely cracked ice in a glass and then half fill it with cold 
apoilinaris, vichy, clysmic or carbonic water as preferred, then quickly 
pour in the peptonised milk and drink during effervescence. 

Peptonised milk may be made agreeable to many patients by serving 
with a little grated nutmeg, sweetened, or flavored with a little brandy, 
etc. 

SPECIALLY PEPTONISED MILK. 

For Jellies, Punches, Etc. 

for all recipes where the milk is to be mixed with fruit juices 

OR ACIDS. 

Mix the peptonising powder, water and milk, in a bottle, and place in 



121 

a hot water-bath exactly as directed in the warm process recipe. Now 
let the bottle remain in the hot water for one hour, then pour into a 
saucepan and heat TO boiling. This specially peptonised milk is now 
ready for use in making jellies, etc. It may be immediately used if re- 
quired hot, or set aside on ice for punches, etc. 

In peptonising milk for all these recipes in which lemon juice or acid 
is to be used, it is necessary to carry the process to the point at which 
the milk will not curdle with acid. Hence the one hour digestion. 

Do not fail to boil the milk immediately after the one hour in water-bath 
in order to kill the peptonising ferment which would otherwise digest the 
gelatine when added and thus prevent the milk from forming a jelly. 

The bitter taste of the milk so peptonised, is entirely absent from the 
jellies, punches, etc., and these foods containing milk in a completely 
digested form are not only agreeable, but exceedingly assimilable. 

PEPTONISED MILK JELLY. 

First take about half a box of Cox's Gelatine and set it aside to soak in 
a teacupful of cold water until needed. 

Take one pint of hot " specially" peptonised milk and dissolve in it 
about a quarter of a pound of sugar, or sufficient to taste, next add 
the gelatine and stir until dissolved. 

Pare one fresh lemon and one orange, and put the rinds into the hot 
peptonised milk. 

Squeeze the lemon and orange juice into a glass, strain, and mix it 
with two or three tablespoonfuls of best St. Croix Rum, or brandy, etc., 
as may be preferred. 

Lastly add the juices and the spirits with stirring. 

Strain all through a colander and when cooled to a syrup consistency, 
so as to be almost ready to " set," pour into tumblers or jelly moulds and 
put in a cold place. 

It is important not to pour the milk into the moulds until it is nearly 
cool, otherwise it will separate in setting. 

This jelly has a delicious flavor, is highly acceptable to invalids and 
convalescents at the period when they tire of liquids and crave more sub- 
stantial food. 

Good St. Croix Rum is generally preferable to other spirits in making 
jellies, punches, etc. 

PEPTONISED MILK 'PUNCH. 
Prepare a punch from peptonised in the same manner as from or- 



122 

dinary milk, using St. Croix or Jamaica Rum, Whiskey or Brandy as pre- 
ferred, and served with grated nutmeg. 

This is a good way : 

Take a goblet about one-third full of fine crushed ice, pour on it a 
tablespoonful of St. Croix Rum, a dash of Curac;oa, or other liquor that 
is agreeable to the taste, then fill the glass with peptonised milk, stirring 
well, sweeten to taste, grate a little nutmeg on top. 

PEPTONISED MILK LEMONADE. 

Take a goblet one-third full of cracked ice, squeeze on it the juice of a 
lemon, and dissolve sufficient sugar, then fill the glass with specially pep- 
tonised milk, stirring well. 

Make this lemonade of equal parts of peptonised milk and mineral 
water, instead of milk alone, if you prefer, first pouring the water, lemon 
juice, etc., on the ice, and then filling the glass with the milk. 

This makes an effervescing punch that is very agreeable. 

PEPTONISED MILK GRUEL. 

Mix smoothly a heaping teaspoonful of wheat flour or arrowroot, with 
half pint of cold water. Then heat with constant stirring until it has 
boiled briskly for several minutes. 

Mix with this hot gruel one pint of cold milk and sfrain into a small 
pitcher or jar, and immediately add the contents of one ' ' peptonising 
tube," mix well. Let it stand in the hot water-bath, or warm place, for 
20 minutes, then put in a clean quart bottle and place on ice 

This milk gruel may be used in the same manner and for the same pur- 
pose as plain peptonised milk. 

The flavor of this milk gruel is very agreeable ; the taste of the pep- 
tone being masked by the digested arrowroot or flour, the peptonising 
powder digesting both the farinaceous matter and the milk. 

PEPTONISED MILK WITH PORRIDGE. 

To a dish of porridge of oatmeal, rice, hominy, etc., as prepared 
for the table, add a sufficient quantity of hot or cold peptonised 
milk. 

It will aid in the digestion of farinaceous foods for young children, as 
well as supplying the milk in a form especially adapted for children with 
defective digestion. 



123 
PEPTONISED BEEF. 

Take one-quarter pound finely minced, raw lean beef, or same weight 
(of equal portions) of beef and chicken meat mixed. 

Cold water, half a pint. 

Cook over a gentle fire, stirring constantly until it has boiled a few 
minutes. 

Then pour off the liquor, for future use, and beat or rub the meat to a 
paste, and put it into a clean fruit jar or bottle with half a pint of cold 
water and the liquor poured from the meat. 

Add— 

Extractum Pancreatis 4 measures (20 grains). 

Soda Bicarb 1 measure (15 grains). 

Shake all well together, and set aside in a warm place, at about 1 10° to 
115 , for three hours, stirring or shaking occasionally ; then boil quickly. 

It may then be strained, or clarified with white of egg, in usual man- 
ner. Season to taste with salt and pepper. 

For great majority of cases it will not be required to strain the pep- 
tonised liquor, for the portion of meat remaining undissolved will have 
been so softened and acted upon, by the pancreatic extract, that it will 
be in very fine particles and diffused in an almost impalpable condition. 
Thus in a form readily subject to digestion in the stomach. 

Farinaceous materials may also be advantageously used in the prep- 
aration of the peptonised soup, by simply boiling a sufficient quantity of 
flour, arrowroot, etc., with a half portion of the water used in above re- 
cipe, and mixing all together — meat, gruel, Extractum Pancreatis and 
Soda. The Extractum Pancreatis will, at the same time, digest both 
starch and meat. 

This has a more agreeable flavor than that made of meats alone. 

Jelly also may be made of peptonised beef. 

Be sure to boil the peptonised beef, after three hours in warm place, 
otherwise the digestion will progress until it is spoiled. 

PEPTONISED OYSTERS. 

(Originally suggested by Dr. N. A. Randolph ) 

Take half a dozen large oysters with their juice and half a pint of 
water. Heat in a saucepan until they have boiled briskly for a few min- 
utes. Pour off the broth and set aside. 

Mince the oysters finely, and reduce them to a paste with a potato 
masher in a wooden bowl. 



124 

Now put the oysters in a glass jar with the broth which has been set 
aside and add 

Extractum Pancreatis 3 measures (15 grains). 

Soda Bicarb 1 measure (15 grains). 

Let the jar stand in hot water or a warm place where the temperature 
is not above 115 degrees, for one and a half hours. 

Then pour into a saucepan and add half a pint of milk. 

Heat over the fire slowly to boiling point. 

Flavor with salt and pepper, or condiments, to taste and serve hot. 

There will be found but very small bits of the oysters undigested, and 
these may be strained out or rejected in eating the soup, but will not be 
unacceptable to the stomach, except in very rare cases. 

The milk will be sufficiently digested during the few minutes which 
will elapse before the mixture boils, if heated gradually. 

Be sure to boil the peptonised oysters to finish the process. 

JUNKET, OR CURDS AND WHEY, 

WITH 

FAIRCHILD'S ESSENCE OF PEPSINE. 

Junket, the soft jelly-like curded milk as prepared with Fairchild's Es- 
sence of Pepsine, is a delicious delicacy for invalids, convalescents and 
dyspeptics. It is especially acceptable and appropriate in convalescence \ 
when the liquid foods have become tiresome and repulsive. This 
junket gives the grateful and wholesome sense of substance, whilst it 
does not oppress the digestion. 

Take half a pint of fresh milk heated lukewarm, add one teaspoonful 
of Essence of Pepsine, and stir just enough to mix. Pour into cus- 
tard cups, let it stand till firmly curded ; may be served plain or with 
sugar and grated nutmeg. 

AS A DESSERT, junket when served with cream, sweetened and flav- 
ored with nutmeg or wine, is far more toothsome than more elaborate 
dishes and has the merit of requiring but a few minutes and no special 
skill in its preparation. 

JUNKET OF MILK AND EGG, 

MADE WITH 

FAIRCHILD'S ESSENCE OF PEPSINE. 

Beat one Qgg to a froth and sweeten with two teaspoonfuls of white 
sugar, add this to half a pint of warm milk ; then add one teaspoonful of 



125 

Essence of Pepsine, let it stand till curded. This milk and egg junket 
is a highly nutritious and agreeable food. 

WHEY 

MADE WITH 

FAIRCHILD'S ESSENCE OF PEPSINE. 

Take half a pint of fresh milk heated lukewarm, (about n 5° F) add one 
teaspoonful of Essence of Pepsine and stir just enough to mix ; when 
firmly curded, beat up with a fork until the curd is finely divided, now 
strain and the Whey is ready for use. Whey contains in solution the 
soluble albuminoids, the sugar and the salts (mineral constituents) of the 
milk and a small portion of fat. 

It is therefore a nutritious fluid food peculiarly useful in many ail- 
ments and always valuable as a means of variety in diet for the sick. 
It is frequently resorted to as a food for infants to tide over periods of 
indigestion, summer complaints, etc. Whey is in some cases indicated 
with wine or brandy and may then be mixed with the spirit. 

Whey, or curds and whey, as made with Fairchild 's Essence of Pepsine 
is superior to that made with liquid rennet, because of the peptic as well 
as the curdling activity of the Essence, and is moreover far more acceptable 
to the stomach. (For use of Whey in Cholera Infantum see pages 96-97.) 

THE PARTIAL DIGESTION OF FARINACEOUS FOODS 
AT THE TABLE. 

To a saucer of well-cooked porridge of oatmeal, wheaten grits or rice, 
etc., as warm as proper to be eaten, add one to two teaspoonfuls Bias- 
tasic Essence of Pancreas. Stir for a few minutes until thoroughly mixed, 
before eating it. 

The Diastasic Essence must not be added to very hot food, for if hot- 
ter than can be agreeably borne by the mouth, the digestive principle 
will be destroyed. 

Extractum Pancreatis may be added in exactly the same manner, using 
a measure full of the dry Extractum Pancreatis instead of the teaspoon- 
ful of Diastasic Essence. The powder imparts no taste or odor to the 
food and is handy to use. It further contains every digestive principle — 
those capable of digesting milk, fat, etc., and thus will aid in the diges- 
tion of the ordinary foods taken at the same meal with the porridge. 



Fairchild's Preparations. 



Pepsin in Scales, 

Pepsin in Powder, 

Essence of Pepsine, 

Saccharated Pepsin, 

Glycerinum Pepticum, 

Extractum Pancreatis, 

Diastasic Essence of Pancreas, 

Peptonising Tubes, 

Peptogenic Milk Powder, 

Panopepton, 

Pancreatic Tablets, 

Compound Pancreatic Tablets, 

Pepsin and Extract Pancreatis Tablets, 

Pepsin and Bismuth Tablets, 

Pepsin, Bismuth and Pancreatic Tablets, 

Pepsin, Bismuth and Nux Vom. Tablets, 

Pepsin and Diastase Tablets, 

Peptonate of Iron Tablets, 

Compound Ox Gall Tablets, 

Ferroglobin Tablets, 

Trypsin. 




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